NPIMap

Organization Active NPI

Advanced Dysphagia Diagnostics LLC

  • Speech-Language Pathologist
  • Shippenville, PA
National Provider Identifier
1891339156
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
ADVANCED DYSPHAGIA DIAGNOSTICS LLC
Practice address
206 Main St
Shippenville, PA 16254-3906
Phone
(909) 213-5967
Fax
(509) 356-4607
NPI assigned
Oct 30, 2019
Last updated
Oct 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Authorized official

Name
Kimberly A Gemmell, SLP
Title
Owner
Phone
(909) 213-5967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

206 Main St
Shippenville, PA 16254-3906

Mailing address

2233 E Main St
Montrose, CO 81401-3831
Phone (970) 765-0818

National Provider Directory

National Provider Directory
Tax ID family
Advanced Dysphagia Diagnostics LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1891339156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 E MAIN ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013831",
            "telephone_number": "970-765-0818",
            "fax_number": "970-497-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MAIN ST",
            "city": "SHIPPENVILLE",
            "state": "PA",
            "postal_code": "162543906",
            "telephone_number": "909-213-5967",
            "fax_number": "509-356-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DYSPHAGIA DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "GEMMELL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-213-5967",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shippenville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.