Individual provider Active NPI

Debra Gunnip, M.S.

  • Speech-Language Pathologist
  • Southbury, CT
National Provider Identifier
1386033611
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
03-114022 Issued in CT
Practice address
1 Reservoir Office Park Ste 104
1449 Old Waterbury Road
Southbury, CT 06488-3926
Phone
(203) 262-9910
NPI assigned
Jan 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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 03-114022 CT Primary

Addresses

Primary practice location

1 Reservoir Office Park Ste 104
1449 Old Waterbury Road
Southbury, CT 06488-3926

Mailing address

104 W Hyerdale Dr
Goshen, CT 06756-1705
Phone (860) 491-3004

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
03-114022CTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1386033611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W HYERDALE DR",
            "city": "GOSHEN",
            "state": "CT",
            "postal_code": "067561705",
            "telephone_number": "860-491-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RESERVOIR OFFICE PARK STE 104",
            "address_2": "1449 OLD WATERBURY ROAD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883926",
            "telephone_number": "203-262-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNNIP",
        "first_name": "DEBRA",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "03-114022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.