Jennifer M Nudo

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL005591L

Practice address

400 E 2ND St
Centennial Hall
Bloomsburg, PA 17815-1301

Phone

(570) 389-5380

Fax

(570) 389-5022

NPI assigned

May 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer M Nudo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1679782437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1388",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040388",
            "telephone_number": "570-288-8881",
            "fax_number": "570-288-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 2ND ST",
            "address_2": "CENTENNIAL HALL",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151301",
            "telephone_number": "570-389-5380",
            "fax_number": "570-389-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUDO",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "SL005591L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017610630005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "NUDO",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Bloomsburg, PA
• Providers in Bloomsburg, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.