Individual provider Active NPI

Sherry L Gatling, HAIR STYLIST

  • Durable Medical Equipment & Medical Supplies
  • Waterbury, CT
National Provider Identifier
1417208448
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Practice address
394 Mill Street
2ND FLR N
Waterbury, CT 06706
Phone
(203) 206-1412
NPI assigned
Oct 1, 2012
Last updated
Oct 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

394 Mill Street
2ND FLR N
Waterbury, CT 06706

Mailing address

45 Freight Street #1
Waterbury, CT 06702
Phone (203) 206-1412

Other identifiers 2

IdentifierTypeStateIssuer
1962OtherCTHAIR AND SKIN PRODUCTS
1962OtherCTPROVIDER FOR CRANIAL PROSTHESIS

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1417208448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 FREIGHT STREET #1",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06702",
            "telephone_number": "203-206-1412",
            "fax_number": "203-753-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 MILL STREET",
            "address_2": "2ND FLR N",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06706",
            "telephone_number": "203-206-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATLING",
        "first_name": "SHERRY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "HAIR STYLIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAIR AND SKIN PRODUCTS",
            "identifier": "1962",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER FOR CRANIAL PROSTHESIS",
            "identifier": "1962",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.