Individual provider Active NPI

Gianna Venafra

  • Speech-Language Pathologist
  • Wyncote, PA
National Provider Identifier
1770302853
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PSL002692 Issued in PA
Practice address
1245 Church Rd
Wyncote, PA 19095-1800
Phone
(215) 884-9990
NPI assigned
Oct 7, 2024
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X PSL002692 PA Primary

Addresses

Primary practice location

1245 Church Rd
Wyncote, PA 19095-1800

Mailing address

9338 Edmund St
Philadelphia, PA 19114-4006
Phone (215) 630-3086

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
PSL002692PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1770302853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9338 EDMUND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144006",
            "telephone_number": "215-630-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 CHURCH RD",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951800",
            "telephone_number": "215-884-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENAFRA",
        "first_name": "GIANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "PSL002692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyncote, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.