Individual provider Active NPI

Makeda Dafina Guy-Governali, MS CCC SLP

  • Speech-Language Pathologist
  • Jamaica, NY
National Provider Identifier
1841582764
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
016582-1 Issued in NY
Practice address
11961 178TH St
Jamaica, NY 11434-1962
Phone
(718) 813-0288
NPI assigned
May 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 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 016582-1 NY Primary

Addresses

Primary practice location

11961 178TH St
Jamaica, NY 11434-1962

Mailing address

11961 178TH St
Jamaica, NY 11434-1962
Phone (781) 813-0288

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

LicenseStateTypeSpecialty
016582-1NYMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1841582764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11961 178TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341962",
            "telephone_number": "781-813-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11961 178TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341962",
            "telephone_number": "718-813-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUY-GOVERNALI",
        "first_name": "MAKEDA",
        "middle_name": "DAFINA",
        "credential": "MS CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-11",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016582-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

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