Kelly M Gousset

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160002729 Issued in IL

Practice address

1509 Farnsworth
Aurora, IL 60505

Phone

(630) 585-5901

NPI assigned

May 28, 2008

Sex

Female

Sole proprietor

Yes

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.

• Willow Therapeutics

  • Physical Therapist
  • Plainfield, IL
  • NPI 1821168204
  NPD (past)

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1194983007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2103",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605672103",
            "telephone_number": "630-428-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 FARNSWORTH",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60505",
            "telephone_number": "630-585-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUSSET",
        "first_name": "KELLY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160002729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Jo Gough, M.A., CCC-SLP/L
• Lauren Gould
• Neal Gould, CRNA
• Ryan William Gould, MHP B.S.
• Shamika Gould
• Nirmala C Govinda, M.D.
• Soha Gowani, APN
• Diviya Goyal
• Shuchi Goyal
• Angelina Goyco-Williams, FNP-BC

• Physical Therapy Assistant in Aurora, IL
• Providers in Aurora, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.

Verify at the official NPI Registry.