Active NPI
Rogea Vincetta Gaymon, LPC
- Professional Counselor
- Bonaire, GA
National Provider Identifier
1609249598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC008772
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| APC004422 | GA | MD | Professional Counselor |
| LPC008772 | GA | MD | Professional 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.