Individual provider Active NPI

Lynn Ann Ewaskiw-Gordon, MS, CCC-SLP

  • Speech-Language Pathologist
  • Wilkes Barre, PA
National Provider Identifier
1144344870
Registry record updated Aug 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL007151 Issued in PA
Practice address
200 S Meade St
Wilkes Barre, PA 18702-6221
Phone
(570) 823-6131
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL007151 PA Primary

Addresses

Primary practice location

200 S Meade St
Wilkes Barre, PA 18702-6221

Mailing address

1036 E Elm St
Scranton, PA 18505-2413
Phone (570) 342-2686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SL007151PAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249948800000",
    "number": "1144344870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 E ELM ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052413",
            "telephone_number": "570-342-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MEADE ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187026221",
            "telephone_number": "570-823-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWASKIW-GORDON",
        "first_name": "LYNN",
        "middle_name": "ANN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2009-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL007151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.