Active NPI
Cori Gondola, LPN
- Licensed Practical Nurse
- Fort Pierce, FL
National Provider Identifier
1396863858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN5153370
- Practice address
- 725 N Us1
Fort Pierce, FL 34950-1168 - Phone
- (772) 468-9900
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN5153370 | FL | Primary |
Addresses
Primary practice location
725 N Us1
Fort Pierce, FL 34950-1168
Mailing address
725 N Us1
Fort Pierce, FL 34950-4404
Other practice location 1
1255 37th St Ste C
Vero Beach, FL 32960-6550
Phone (772) 468-9900 ext. 5154
Other practice location 2
981 37th Pl
Vero Beach, FL 32960-6541
Phone (772) 468-9900 ext. 5154
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
| License | State | Type | Specialty |
|---|---|---|---|
| PN5153370 | FL | MD | Licensed Practical Nurse |
Interoperability endpoints
- cori.gondola.1@14627.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711670400000",
"number": "1396863858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 N US1",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349504404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 N US1",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349501168",
"telephone_number": "772-468-9900"
}
],
"practiceLocations": [
{
"address_1": "1255 37th St Ste C",
"address_purpose": "LOCATION",
"city": "Vero Beach",
"state": "FL",
"postal_code": "329606550",
"country_code": "US",
"telephone_number": "772-468-9900 x5154",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "981 37th Pl",
"address_purpose": "LOCATION",
"city": "Vero Beach",
"state": "FL",
"postal_code": "329606541",
"country_code": "US",
"telephone_number": "772-468-9900 x5154",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONDOLA",
"first_name": "CORI",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2024-03-29",
"certification_date": "2024-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN5153370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.