Geralyn Koblis, MA. CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2005 Issued in NH

Practice address

547 US Route 4
Enfield, NH 03748-3201

Phone

(603) 632-5563

NPI assigned

Mar 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Boothby Therapy Services, LLC

  • Occupational Therapist
  • Laconia, NH
  • NPI 1770797094
  NPD (past)
• Mascoma Valley Regional School District

  • Local Education Agency (LEA)
  • Enfield, NH
  • NPI 1114131190
  NPD (past)

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1003491945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOOTHBY THERAPY SERVICES",
            "address_2": "806 NORTH MAIN STREET",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "03246",
            "telephone_number": "603-524-9090",
            "fax_number": "603-524-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 US ROUTE 4",
            "city": "ENFIELD",
            "state": "NH",
            "postal_code": "037483201",
            "telephone_number": "603-632-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBLIS",
        "first_name": "GERALYN",
        "credential": "MA. CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NH",
            "license": "2005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Holcomb, PH.D.
• Inner Voyage Mental Health PLLC
• Keene Medical Products LLC
• Keene Medical Products, LLC
• Robin Kloos, MS/CCC-SLP
• Angela Katherine Lacey, DPT
• Diane Marie Legendre, RN
• Lincare Inc
• Elaine Marie Mahoney, MA CCCSLP
• Katherine T Marciniszyn, DMD

• Speech-Language Pathologist in Enfield, NH
• Providers in Enfield, NH by specialty
• Speech-Language Pathologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.