Active NPI
Teresa Marie Gahagan, M.A.-CCC
- Speech-Language Pathologist
- Overland Park, KS
National Provider Identifier
1104082130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 00459
- Practice address
- 11521 Mastin St
Overland Park, KS 66210-2966 - Phone
- (816) 853-4126
- NPI assigned
- Jul 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 00459 | KS | Primary |
Addresses
Primary practice location
11521 Mastin St
Overland Park, KS 66210-2966
Mailing address
11521 Mastin St
Overland Park, KS 66210-2966
Phone (816) 853-4126
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00459 | KS | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217289600000",
"number": "1104082130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11521 MASTIN ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662102966",
"telephone_number": "816-853-4126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11521 MASTIN ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662102966",
"telephone_number": "816-853-4126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAHAGAN",
"first_name": "TERESA",
"middle_name": "MARIE",
"credential": "M.A.-CCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-29",
"last_updated": "2008-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "KS",
"license": "00459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.