Organization Active NPI

Gnoodle

  • Speech-Language Pathologist
  • Santa Rosa, CA
National Provider Identifier
1962160655
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
GNOODLE
Practice address
5460 Skylane Blvd Ste C
Santa Rosa, CA 95403-1793
Phone
(775) 354-9706
NPI assigned
Nov 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Authorized official

Name
Thomas Bishop, MSNPI 1811200298
Title
Executive Director
Phone
(775) 354-9706

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

5460 Skylane Blvd Ste C
Santa Rosa, CA 95403-1793

Mailing address

422 Larkfield Ctr # 310
Santa Rosa, CA 95403-1408
Phone (775) 354-9706

National Provider Directory

National Provider Directory

Locations

5460 Skylane Blvd
Ste C
Santa Rosa, CA 95403
Phone (707) 755-5060

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1962160655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 LARKFIELD CTR # 310",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031408",
            "telephone_number": "775-354-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 SKYLANE BLVD STE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031793",
            "telephone_number": "775-354-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GNOODLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "775-354-9706",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

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