Jacquelyn Marie Gerg, MS CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL010050 Issued in PA

Practice address

15 W Willow St
Smethport, PA 16749-1523

Phone

(814) 887-5716

NPI assigned

Sep 27, 2011

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

Other names 1

• Jacquelyn Marie Herbstritt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1073896965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E ARCH ST",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158571705",
            "telephone_number": "814-335-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W WILLOW ST",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167491523",
            "telephone_number": "814-887-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERG",
        "first_name": "JACQUELYN",
        "middle_name": "MARIE",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL010050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "HERBSTRITT",
            "middle_name": "MARIE",
            "credential": "MS CCC SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Colson, CRNP
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• Renato Domenack Casas, MD
• Kerri Fitch, RN
• Andrew Christopher Forrestel, MD
• Jamie Jividen, RDH
• James B. Kane Jr., DMD
• Mary Christine Keglovits
• Keystone Rural Health Consortia, Inc.
• Kio Chiropractic

• Speech-Language Pathologist in Smethport, PA
• Providers in Smethport, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.