Active NPI
Jodi Bloomgarden, MS, CCC/SLP
- Speech-Language Pathologist
- Syosset, NY
National Provider Identifier
1821233511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 008244-1
- Practice address
- 47 Humphrey Dr
Syosset, NY 11791-4022 - Phone
- (516) 921-7171
- NPI assigned
- Dec 9, 2008
- 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 | 008244-1 | NY | Primary |
Addresses
Primary practice location
47 Humphrey Dr
Syosset, NY 11791-4022
Mailing address
47 Humphrey Dr
Syosset, NY 11791-4022
Phone (516) 921-7171
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008244-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228780800000",
"number": "1821233511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 HUMPHREY DR",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117914022",
"telephone_number": "516-921-7171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 HUMPHREY DR",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117914022",
"telephone_number": "516-921-7171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOMGARDEN",
"first_name": "JODI",
"name_prefix": "Ms.",
"credential": "MS, CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-09",
"last_updated": "2008-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "008244-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syosset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.