Jacqueline Goertzen, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1784 Issued in NE

Practice address

2300 W Capital Ave
Grand Island, NE 68803-2003

Phone

(308) 385-6252

NPI assigned

May 31, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1427319904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W CAPITAL AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688032003",
            "telephone_number": "308-385-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOERTZEN",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Go Physical Therapy, LLC
• Richard E Goble, M.D.
• Amanada Godding
• John David Goering, M.D.
• Elizabeth Goertzen
• Agnes Gomes, MD
• Malillany D Gomez
• Milagros Carlota Gonzalez Cespedes
• Maximo Lucas Gonzalez Escalona
• Laura Teresa Gonzalez Perdomo

• Speech-Language Pathologist in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Speech-Language Pathologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.