Individual provider Active NPI

Madison A Gates, SLP

  • Speech-Language Pathologist
  • Waverly, IA
National Provider Identifier
1578093399
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
087245 Issued in IA
Practice address
217 E Bremer Ave
Waverly, IA 50677-3435
Phone
(319) 352-4544
Fax
(319) 352-4655
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 087245 IA Primary

Addresses

Primary practice location

217 E Bremer Ave
Waverly, IA 50677-3435

Mailing address

217 E Bremer Ave
Waverly, IA 50677-3435
Phone (319) 352-4544

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

LicenseStateTypeSpecialty
087245IAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578093399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 E BREMER AVE",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506773435",
            "telephone_number": "319-352-4544",
            "fax_number": "319-352-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E BREMER AVE",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506773435",
            "telephone_number": "319-352-4544",
            "fax_number": "319-352-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "MADISON",
        "middle_name": "A",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "087245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.