Individual provider Active NPI

Kriste Gill

  • Speech-Language Pathologist
  • Milford, MA
National Provider Identifier
1356981070
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
003016 Issued in CT
Practice address
321 Fortune Blvd # 202
Milford, MA 01757-1750
Phone
(860) 613-9930
Fax
(860) 613-9952
NPI assigned
Jan 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 003016 CT Primary

Addresses

Primary practice location

321 Fortune Blvd # 202
Milford, MA 01757-1750

Mailing address

62 West Street
Suite F
Cromwell, CT 06416-4405
Phone (860) 613-9930

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

LicenseStateTypeSpecialty
003016CTMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1356981070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 WEST STREET",
            "address_2": "SUITE F",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064164405",
            "telephone_number": "860-613-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 FORTUNE BLVD # 202",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571750",
            "telephone_number": "860-613-9930",
            "fax_number": "860-613-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "KRISTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "003016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; 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.