Individual provider Active NPI

Cori Gondola, LPN

  • Licensed Practical Nurse
  • Fort Pierce, FL
National Provider Identifier
1396863858
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5153370 Issued in FL
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

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PN5153370FLMDLicensed Practical Nurse

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.