Jennifer Gollus, M.S., OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

011379 Issued in NY

Practice address

10674 Prospect St
Gowanda, NY 14070-1344

Phone

(716) 532-3325

NPI assigned

Dec 14, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• James Klubek

  • Local Education Agency (LEA)
  • Gowanda, NY
  • NPI 1891974499
  NPD (past)

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1396014783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 TRICIA LN",
            "city": "BOSTON",
            "state": "NY",
            "postal_code": "140259641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10674 PROSPECT ST",
            "city": "GOWANDA",
            "state": "NY",
            "postal_code": "140701344",
            "telephone_number": "716-532-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLUS",
        "first_name": "JENNIFER",
        "credential": "M.S., OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-14",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "011379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Laurie Della Vella, SLP
• Robert Dowrey, DDS
• Lynn Edminster, LPN
• G N H LLC
• GNH LLC
• Gornc Operating LLC
• Gowanda Ambulance Service Corp
• Gowanda Central School
• Gowanda Correctional Facility
• Gowanda Eye Care, Inc.

• Pediatric Occupational Therapist in Gowanda, NY
• Providers in Gowanda, NY by specialty
• Pediatric Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.