Individual provider Active NPI

Gretchen L Hadar, M.ED., CCC-SLP

  • Speech-Language Pathologist
  • Indianapolis, IN
National Provider Identifier
1629103429
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22003897A Issued in IN
Practice address
5221 Cornelius Ave
Indianapolis, IN 46208-2511
Phone
(317) 627-5770
Fax
(317) 726-0944
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2008

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 22003897A IN Primary

Addresses

Primary practice location

5221 Cornelius Ave
Indianapolis, IN 46208-2511

Mailing address

5221 Cornelius Ave
Indianapolis, IN 46208-2511
Phone (317) 627-5770

Other identifiers 1

IdentifierTypeStateIssuer
200678020MedicaidIN

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
22003897AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1629103429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 CORNELIUS AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462082511",
            "telephone_number": "317-627-5770",
            "fax_number": "317-726-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5221 CORNELIUS AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462082511",
            "telephone_number": "317-627-5770",
            "fax_number": "317-726-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADAR",
        "first_name": "GRETCHEN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "M.ED., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003897A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200678020",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.