Individual provider Active NPI

Gail Ann Niemann, SLP

  • Speech-Language Pathologist
  • Bernalillo, NM
National Provider Identifier
1376696765
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1556 Issued in NM
Practice address
224 N Camino del Pueblo
Bernalillo, NM 87004-6146
Phone
(505) 404-5376
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1556 NM Primary

Addresses

Primary practice location

224 N Camino del Pueblo
Bernalillo, NM 87004-6146

Mailing address

907 Green Acre PL NW
Albuquerque, NM 87104
Phone (505) 842-1366

Other identifiers 1

IdentifierTypeStateIssuer
L4664MedicaidNM

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
1556NMMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376696765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 GREEN ACRE PL NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87104",
            "telephone_number": "505-842-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 N CAMINO DEL PUEBLO",
            "city": "BERNALILLO",
            "state": "NM",
            "postal_code": "870046146",
            "telephone_number": "505-404-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMANN",
        "first_name": "GAIL",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "1556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L4664",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bernalillo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.