Active NPI
Jaclynn Gostomski
- Speech-Language Pathologist
- Piqua, OH
National Provider Identifier
1649883802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- COND.20201351-SP
- Practice address
- 800 N Sunset Dr
Piqua, OH 45356-4440 - Phone
- (937) 339-5100
- NPI assigned
- Aug 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | COND.20201351-SP | OH | Primary |
Addresses
Primary practice location
800 N Sunset Dr
Piqua, OH 45356-4440
Mailing address
2000 W Stanfield Rd
Troy, OH 45373-2572
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 |
|---|---|---|---|
| COND.20201351-SP | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1649883802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 W STANFIELD RD",
"city": "TROY",
"state": "OH",
"postal_code": "453732572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 N SUNSET DR",
"city": "PIQUA",
"state": "OH",
"postal_code": "453564440",
"telephone_number": "937-339-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSTOMSKI",
"first_name": "JACLYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-27",
"last_updated": "2020-08-27",
"certification_date": "2020-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "COND.20201351-SP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Piqua, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.