Individual provider Active NPI

Gwendolyn M Crawford, M. ED SLP

  • Speech-Language Pathologist
  • Baton Rouge, LA
National Provider Identifier
1609058148
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3755 Issued in LA
Practice address
11817 Parkmount Blvd
Baton Rouge, LA 70816-4630
Phone
(225) 292-4898
NPI assigned
Nov 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3755 LA Primary

Addresses

Primary practice location

11817 Parkmount Blvd
Baton Rouge, LA 70816-4630

Mailing address

11817 Parkmount Blvd
Baton Rouge, LA 70816-4630
Phone (225) 292-4898

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
3755LAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1609058148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11817 PARKMOUNT BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164630",
            "telephone_number": "225-292-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11817 PARKMOUNT BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164630",
            "telephone_number": "225-292-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "GWENDOLYN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "M. ED  SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "3755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.