Individual provider Active NPI

John Blair O'Gorman, MS CCC-SLP

  • Speech-Language Pathologist
  • Reno, NV
National Provider Identifier
1346798501
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-1071 Issued in NV
Practice address
2667 Enterprise Rd
Reno, NV 89512-1666
Phone
(775) 338-3857
NPI assigned
Sep 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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 SP-1071 NV Primary

Addresses

Primary practice location

2667 Enterprise Rd
Reno, NV 89512-1666

Mailing address

1448 Orca Way
Reno, NV 89506-6608

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
SP-1071NVMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1346798501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 ORCA WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895066608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2667 ENTERPRISE RD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895121666",
            "telephone_number": "775-338-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'GORMAN",
        "first_name": "JOHN",
        "middle_name": "BLAIR",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP-1071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.