Individual provider Active NPI

Claire Goecke, MA

  • Speech-Language Pathologist
  • Worthington, OH
National Provider Identifier
1700558244
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
COND20211691-SP Issued in OH
Practice address
951 High St Lowr Level
Worthington, OH 43085-4099
Phone
(956) 237-6894
Fax
(614) 670-7427
NPI assigned
Oct 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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 COND20211691-SP OH Primary

Addresses

Primary practice location

951 High St Lowr Level
Worthington, OH 43085-4099

Mailing address

951 High St Lowr Level
Worthington, OH 43085-4099
Phone (956) 237-6894

Other practice location 1

523 E Engler St
Columbus, OH 43215-5551
Phone (956) 237-6894

Other identifiers 1

IdentifierTypeStateIssuer
0306774MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.fusionwebclinic.com Health Information Exchange (HIE)

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 Arts

State licenses

LicenseStateTypeSpecialty
COND20211691-SPOHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1700558244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 HIGH ST LOWR LEVEL",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430854099",
            "telephone_number": "956-237-6894",
            "fax_number": "614-670-7427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 HIGH ST LOWR LEVEL",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430854099",
            "telephone_number": "956-237-6894",
            "fax_number": "614-670-7427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "523 E Engler St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432155551",
            "country_code": "US",
            "telephone_number": "956-237-6894",
            "fax_number": "614-670-7427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOECKE",
        "first_name": "CLAIRE",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "COND20211691-SP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0306774",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.fusionwebclinic.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "951 High St Lowr Level",
            "city": "Worthington",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430854099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.