Active NPI
Gretchen Windom Badon
- Speech-Language Pathologist
- Covington, LA
National Provider Identifier
1750537478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5191
- Practice address
- 63 Lurline Dr
Covington, LA 70433-1048 - Phone
- (985) 871-1758
- NPI assigned
- Aug 13, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 5191 | LA | Primary |
Addresses
Primary practice location
63 Lurline Dr
Covington, LA 70433-1048
Mailing address
63 Lurline Dr
Covington, LA 70433-1048
Phone (985) 871-1758
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477028 | Medicaid | LA |
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 |
|---|---|---|---|
| 5191 | LA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245801600000",
"number": "1750537478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 LURLINE DR",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704331048",
"telephone_number": "985-871-1758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 LURLINE DR",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704331048",
"telephone_number": "985-871-1758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADON",
"first_name": "GRETCHEN",
"middle_name": "WINDOM",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-13",
"last_updated": "2009-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "5191",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1477028",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covington, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.