KARISSA ANN GONDAK (NPI# 1568079119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568079119 |
| Entity Type | Individual |
| Full Name | KARISSA ANN GONDAK |
| Practice Address |
161 Bakers Ridge Rd Morgantown WV 26508-1459 |
| Practice Telephone | 3042850692 |
| Mailing Telephone | 3042850692 |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 235Z00000X | Speech-Language Pathologist | WV | Speech, Language and Hearing Service Providers | |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
161 BAKERS RIDGE RD |
| City | MORGANTOWN |
| State | WV |
| Zip Code | 26508-1459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730120486 | Gma-madison Inc | Skilled Nursing Facility | 161 Bakers Ridge Rd, Morgantown, WV 26508-1459 | 2006-06-10 |
| 1720629348 | Joseph Laneve | Physical Therapist | 161 Bakers Ridge Rd, Morgantown, WV 26508-1459 | 2019-10-04 |
| 1033675186 | Brandon Robert Shreve | Physical Therapy Assistant | 161 Bakers Ridge Rd, Morgantown, WV 26508-1459 | 2019-02-13 |
| 1861984452 | Kami Kubler | Speech-Language Pathologist | 161 Bakers Ridge Rd, Morgantown, WV 26508-1459 | 2018-05-31 |
| 1801346622 | Heidi Shultz | Physical Therapy Assistant | 161 Bakers Ridge Rd, Morgantown, WV 26508-1459 | 2016-10-04 |
| 1194177659 | Katie Kozulla | Speech-Language Pathologist | 161 Bakers Ridge Rd, Morgantown, WV 26508-1459 | 2016-07-08 |
| 1942654066 | Lauren Mckissick | Specialist | 161 Bakers Ridge Rd, Morgantown, WV 26508-1459 | 2016-04-14 |
| 1932585494 | Megan Carbacio | Occupational Therapist | 161 Bakers Ridge Rd, Morgantown, WV 26508-1459 | 2015-08-07 |
| 1831580125 | Tyler Wamsley | Physical Therapist | 161 Bakers Ridge Rd, Morgantown, WV 26508-1459 | 2015-02-09 |
| 1023427846 | Kristina Beeghly | Physical Therapy Assistant | 161 Bakers Ridge Rd, Morgantown, WV 26505 | 2014-08-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989026 | Ruth Gibson | Technician | 4 Elpaso Ave, Morgantown, WV 26508 | 2020-10-09 |
| 1518565845 | Anne Jiang | Pharmacist | 7000 Mid Atlantic Dr., Morgantown, WV 26508 | 2020-10-09 |
| 1396356283 | Jessica Dawn Taylor | Technician | Lot 128 Healthy Heights Village, Morgantown, WV 26508 | 2020-08-13 |
| 1992297733 | Jeffrey G Minchau Dds Ms | Dentist | 9000 Coombs Farm Dr, Ste 304, Morgantown, WV 26508 | 2018-06-06 |
| 1346796257 | Gregory Ice | Social Worker | 1627 Grafton Rd, Morgantown, WV 26508 | 2016-08-31 |
| 1306242540 | Mountaineer Psychological Services | Community/Behavioral Health | 4000 Coombs Farm Drive, Bldg D Unit 102, Morgantown, WV 26508 | 2014-11-17 |
| 1750722906 | Tingler Rx | Pharmacy | 889 Venture Drive, Suite 2, Morgantown, WV 26508 | 2013-07-16 |
| 1881033983 | Amy Rodgers Smith | Music Therapist | 714 Venture Drive #115, Morgantown, WV 26508 | 2013-06-21 |
| 1013250588 | Walid Radwan | Student in an Organized Health Care Education/Training Program | 1121 Eagle Run Road, Morgantown, WV 26508 | 2013-04-02 |
| 1467727040 | Sara Lyndsey Disimone | Counselor | 3000 Coombs Farm Road, Suite 102, Morgantown, WV 26508 | 2012-03-15 |
| Find all providers in zip 26508 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396358149 | Jamara Washington | Student in an Organized Health Care Education/Training Program | 5000 Domain Dr Apt 715, Morgantown, WV 26501-2528 | 2020-08-30 |
| 1275146540 | Virginia Fay Honaker | Student in an Organized Health Care Education/Training Program | 5000 Station St Apt 1012, Morgantown, WV 26508-7442 | 2020-08-26 |
| 1487282554 | Michael Joseph Dugan IIi | Student in an Organized Health Care Education/Training Program | 64 Medical Center Dr Rm 1200, Morgantown, WV 26505-3409 | 2020-04-01 |
| 1295363646 | Catherine Maxine Powers | Student in an Organized Health Care Education/Training Program | 385 Dorsey Ave, Morgantown, WV 26501-6460 | 2020-03-31 |
| 1124656491 | Lauren Bakos | Student in an Organized Health Care Education/Training Program | Department of Oral Surgery Room 1200 Hsc North, Morgantown, WV 26506 | 2020-03-31 |
| 1679100127 | Joshua James Hurley | Student in an Organized Health Care Education/Training Program | 17 Van Gilder St, Morgantown, WV 26505-1760 | 2020-03-25 |
| 1629605399 | Rehab Othman Mohamed | Student in an Organized Health Care Education/Training Program | 206 Carmell Ct, Morgantown, WV 26505-7801 | 2020-03-24 |
| 1427684471 | Ameneh Zare Shahabadi | Student in an Organized Health Care Education/Training Program | 1 Medical Center Dr Fl 5, Morgantown, WV 26506-1200 | 2020-03-20 |
| 1831725985 | Ion Prisneac | Student in an Organized Health Care Education/Training Program | 64 Medical Center Dr Rm 4601, Morgantown, WV 26505-3409 | 2020-03-20 |
| 1720613888 | Katharina Marie Mitchell | Student in an Organized Health Care Education/Training Program | Wvu Hospitals Ruby Memorial & Physician Office Center, 1 Medical Center Drive, Morgantown, WV 26506 | 2020-03-10 |
| Find all providers in MORGANTOWN | ||||
| City | MORGANTOWN |
| Zip Code | 26508 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.