Kary J Gillenwaters, OTR/L

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1458 Issued in ND

Practice address

15590 90TH St NE
Otsego, MN 55330-9452

Phone

(763) 755-4275

NPI assigned

Aug 3, 2006

Last updated

Feb 6, 2014By the provider in NPPES

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 identifiers 1

Other names 1

• Kary Reule Former name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Speech & Therapy Services, LLC

  dba Sora Pediatric Therapy

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  • Andover, MN
  • NPI 1235285966
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1316954985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15590 90TH ST NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553309452",
            "telephone_number": "763-755-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15590 90TH ST NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553309452",
            "telephone_number": "763-755-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLENWATERS",
        "first_name": "KARY",
        "middle_name": "J",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ND PIN",
            "identifier": "018808",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARY",
            "last_name": "REULE",
            "credential": "LAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Genus Healthcare Inc
• David John Gerlach, M.D.
• Jennifer Lynn Geryol, MA, LMFT
• Le Ann M Giefer
• Penny Gillen
• GJ Destiny Adult Foster Home, LLC
• Kelly C Gorder, MS, SLP-CCC
• Grand St Paul CVS LLC (CVS Pharmacy #17509)
• Andrea Maureen Gredvig, OTR/L
• Shelly Elaine Green, MSW LICSW

• Addiction (Substance Use Disorder) Counselor in Otsego, MN
• Providers in Otsego, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.