Kerry Gully, MS, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

010709-1 Issued in NY

Practice address

333 Ny 351
Averill Park, NY 12018

Phone

(518) 674-7100

NPI assigned

Jan 6, 2012

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

State licenses

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.

• Averill Park Central School District

  • Local Education Agency (LEA)
  • Averill Park, NY
  • NPI 1053680926
  NPD (past)
• Averill Park School District

  • Case Management Agency
  • Averill Park, NY
  • NPI 1689943573
  NPD (past)

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1467722504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 GETTLE RD",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "120189794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NY 351",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "12018",
            "telephone_number": "518-674-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLY",
        "first_name": "KERRY",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "010709-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Raymond Gamache, DDS
• Brenda Loraine Gausby, LMHC
• Geoffrey R. Gamache DDS PLLC
• Evelynn Ginsburg, RPH
• Amber D Gray, MS, RDN, CDN, CLC
• Michele Haggerty
• Heirloom Lactation, LLC
• Deborah Ann Hildreth, RPA-C
• Robert Halford Hill II, DDS
• Marybeth Ripp Hollinger

• All providers in Averill Park, NY
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.