Ally Marie Gourley

Primary specialty

DentistTaxonomy code 122300000X

License

2026026685 Issued in MO

Practice address

3320 Rutger St
Saint Louis, MO 63104-1122

Phone

(314) 977-7336

NPI assigned

May 11, 2023

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1033809181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 NW CLAYMONT DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641161751",
            "telephone_number": "785-562-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 RUTGER ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041122",
            "telephone_number": "314-977-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURLEY",
        "first_name": "ALLY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2026026685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer E Gould, MD
• Natalie Suzanne Gould, LPC
• Ronald John Gould, M.D.
• Eric Goulden, PHARM.D
• I Regina Gourdine, MSW , LCSW
• Nicholas Gourtzelis, MD
• Kathy Lynn Gouwens, M.A., PLPC
• Laurel J Governal, BCBA
• Christie R Govero, FNP
• Ramaswamy Govindan, MD

• Dentist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.