Individual provider Active NPI

Dolores Bernknopf, C.C.C.-S.L.P.

  • Speech-Language Pathologist
  • Boca Raton, FL
National Provider Identifier
1639394752
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA7095 Issued in FL
Practice address
130 Pine Cir
Boca Raton, FL 33432-3648
Phone
(561) 361-0307
NPI assigned
Apr 16, 2007
Last updated
Aug 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA7095 FL Primary
Developmental Therapist 222Q00000X SA7095 FL

Addresses

Primary practice location

130 Pine Cir
Boca Raton, FL 33432-3648

Mailing address

1600 Parkside Cir S
Boca Raton, FL 33486-8565
Phone (561) 447-1168

Other identifiers 2

IdentifierTypeStateIssuer
888876100MedicaidFL
SA7095OtherFLLICENSE

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
SA7095FLMDDevelopmental Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jonas Therapy Associates, Inc. Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1639394752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PARKSIDE CIR S",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334868565",
            "telephone_number": "561-447-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PINE CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334323648",
            "telephone_number": "561-361-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNKNOPF",
        "first_name": "DOLORES",
        "credential": "C.C.C.-S.L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7095",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": "SA7095",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888876100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "SA7095",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.