Individual provider Active NPI

Rosa Irene Gutierrez Vanegas, MS.SLP

  • Speech-Language Pathologist
  • Falls Church, VA
National Provider Identifier
1154678191
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202007901 Issued in VA
Practice address
307 E Annandale Rd # 208
Falls Church, VA 22042-2454
Phone
(202) 417-6609
NPI assigned
Aug 9, 2012
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 022450 NY
Speech-Language Pathologist 235Z00000X 2202007901 VA Primary

Addresses

Primary practice location

307 E Annandale Rd # 208
Falls Church, VA 22042-2454

Mailing address

301 W Broad St Apt 665
Falls Church, VA 22046-3376
Phone (202) 374-8192

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

State licenses

LicenseStateTypeSpecialty
022450NYMDOccupational Therapist
2202007901VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brainstorm Consulting LLC CurrentSince Jul 23, 2023 Accepting new patients

Locations

307 Annandale Rd
#208
Falls Church, VA 22042
Phone (202) 417-6609

701 W Broad St
Ste 314
Falls Church, VA 22046

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1154678191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BROAD ST APT 665",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463376",
            "telephone_number": "202-374-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E ANNANDALE RD # 208",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220422454",
            "telephone_number": "202-417-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ VANEGAS",
        "first_name": "ROSA IRENE",
        "credential": "MS.SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "022450",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202007901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.