Active NPI
Rebecca Gondak, SLP
- Speech-Language Pathologist
- Millersville, MD
National Provider Identifier
1508928219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5032
- Practice address
- 8638 Veterans Hwy
1St Floor
Millersville, MD 21108-1422 - Phone
- (410) 729-4508
- Fax
- (410) 729-4526
- NPI assigned
- Dec 16, 2006
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5032 | MD | Primary |
Addresses
Primary practice location
8638 Veterans Hwy
1St Floor
Millersville, MD 21108-1422
Mailing address
PO Box 15945
Belfast, ME 04915-4054
Phone (410) 729-4508
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220025200 | Medicaid | MD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5032 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1508928219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15945",
"city": "BELFAST",
"state": "ME",
"postal_code": "049154054",
"telephone_number": "410-729-4508",
"fax_number": "410-729-4526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8638 VETERANS HWY",
"address_2": "1ST FLOOR",
"city": "MILLERSVILLE",
"state": "MD",
"postal_code": "211081422",
"telephone_number": "410-729-4508",
"fax_number": "410-729-4526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONDAK",
"first_name": "REBECCA",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-16",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "5032",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "220025200",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Millersville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.