Active NPI
Theresa Gushaulis, OTR
- Occupational Therapist
- Mountain Top, PA
National Provider Identifier
1407070709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC002342L
- Practice address
- 3011 Nuangola Rd
Mountain Top, PA 18707-9506 - Phone
- (570) 868-5022
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC002342L | PA | Primary |
Addresses
Primary practice location
3011 Nuangola Rd
Mountain Top, PA 18707-9506
Mailing address
3011 Nuangola Rd
Mountain Top, PA 18707-9506
Phone (570) 868-5022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1012893550001 | Medicaid | PA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OC002342L | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250467200000",
"number": "1407070709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3011 NUANGOLA RD",
"city": "MOUNTAIN TOP",
"state": "PA",
"postal_code": "187079506",
"telephone_number": "570-868-5022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3011 NUANGOLA RD",
"city": "MOUNTAIN TOP",
"state": "PA",
"postal_code": "187079506",
"telephone_number": "570-868-5022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSHAULIS",
"first_name": "THERESA",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2009-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC002342L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1012893550001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mountain Top, PA
- Kelly Ann Gownley McCandrew, M.S. CCC-SLP
- Britney A Gregory, MS, LAPC, NCC
- Andrew Gromelski
- Guardian Elder Care at Mountain Top I LLC
- Guiding Light Counseling LLC
- Diane A Hanlon, PFT, CHC
- Amanda Marie Harrison, MS
- Molly Hasay, M.S., LAPC, NCC
- David Michael Havard, PT, DPT, CPT
- Bruce Richard Havera, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.