Individual provider Active NPI

Rogea Vincetta Gaymon, LPC

  • Professional Counselor
  • Bonaire, GA
National Provider Identifier
1609249598
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC008772 Issued in GA
Practice address
211 Bowens Mill Dr
Bonaire, GA 31005-3148
Phone
(478) 960-4728
NPI assigned
Nov 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X APC004422 GA
Professional Counselor 101YP2500X LPC008772 GA Primary

Addresses

Primary practice location

211 Bowens Mill Dr
Bonaire, GA 31005-3148

Mailing address

211 Bowens Mill Dr
Bonaire, GA 31005-3148
Phone (478) 960-4728

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
APC004422GAMDProfessional Counselor
LPC008772GAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1609249598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 BOWENS MILL DR",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310053148",
            "telephone_number": "478-960-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 BOWENS MILL DR",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310053148",
            "telephone_number": "478-960-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYMON",
        "first_name": "ROGEA",
        "middle_name": "VINCETTA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-02",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC004422",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonaire, GA

Sources for this page

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

Verify at the official NPI Registry.