Individual provider Active NPI

Kerrilyn McGowan, AUD

  • Audiologist
  • Worcester, MA
National Provider Identifier
1225680283
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
4784 Issued in MA
Practice address
490 Shrewsbury St Ste 2
Worcester, MA 01604-1607
Phone
(508) 755-1391
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 4784 MA Primary

Addresses

Primary practice location

490 Shrewsbury St Ste 2
Worcester, MA 01604-1607

Mailing address

490 Shrewsbury St Ste 2
Worcester, MA 01604-1607
Phone (508) 755-1391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191210002814 MA Practitioner - Qualified Audiologist 2567895212 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4784MAMDGroup Psychotherapy Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Center, Inc. CurrentSince Aug 3, 2023 Accepting new patients
Umass Memorial Medical Center, Inc. CurrentSince Aug 3, 2023 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jul 9, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jul 9, 2023 Accepting new patients
Audiology Affiliates of Hear Better, Inc Audiologist Past Accepting new patients

Locations

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Organizations & group practices 5

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": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1225680283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 SHREWSBURY ST STE 2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041607",
            "telephone_number": "508-755-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 SHREWSBURY ST STE 2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041607",
            "telephone_number": "508-755-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "KERRILYN",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "4784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.