Individual provider Active NPI

Laura Gibbons

  • Speech-Language Pathologist
  • Hauppauge, NY
National Provider Identifier
1033569025
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1363 Veterans Memorial Hwy Ste 8
Hauppauge, NY 11788-3046
Phone
(631) 366-3876
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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 Primary

Addresses

Primary practice location

1363 Veterans Memorial Hwy Ste 8
Hauppauge, NY 11788-3046

Mailing address

111 Evans Branch CT
Galivants Ferry, SC 29544-8453
Phone (516) 721-3546

Other practice location 1

101 W 116th St
New York, NY 10026-2521
Phone (212) 787-8315

Other practice location 2

299 Hallock Ave
Port Jefferson Station, NY 11776-1217
Phone (631) 473-4284

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Jane Brain Foundation Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1033569025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EVANS BRANCH CT",
            "city": "GALIVANTS FERRY",
            "state": "SC",
            "postal_code": "295448453",
            "telephone_number": "516-721-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1363 VETERANS MEMORIAL HWY STE 8",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883046",
            "telephone_number": "631-366-3876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W 116th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100262521",
            "country_code": "US",
            "telephone_number": "212-787-8315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "299 Hallock Ave",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson Station",
            "state": "NY",
            "postal_code": "117761217",
            "country_code": "US",
            "telephone_number": "631-473-4284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.