Jean C Gonzalez, MS. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

30003174 Issued in NC

Practice address

103 N Plain Rd
Jacksonville, NC 28546-6760

Phone

(910) 298-2331

NPI assigned

Aug 8, 2024

Last updated

Aug 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coastal Speech Therapy Inc

  • Speech-Language Pathologist
  • Wilmington, NC
  • NPI 1750782462
  Medicare reassignment NPD

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1447081831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BARNHOUSE RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285460077",
            "telephone_number": "787-607-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N PLAIN RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466760",
            "telephone_number": "910-298-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JEAN",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MS. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30003174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Goldberg
• Golden Gates Homecare Agency, LLC
• Anna Goldstein
• Carlye Nicole Gomez
• Lindsay Gonyeau, MSW, LCSW
• Owen Gonzalez, CPO
• Shannice Gonzalez
• Kasey Elizabeth Goodman, PT
• Kaylea Goodson, FNP-BC
• Ishwar Hakumal Gopichand, MD

• Speech-Language Pathologist in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.