Gerella Matheos, ITDS

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

13101 Bruce B Downs Blvd
Tampa, FL 33612-3803

Phone

(813) 974-2201

NPI assigned

Feb 26, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Gerella Kenniston Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: gmatheos152592@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1588056683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32891",
            "telephone_number": "813-974-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13101 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123803",
            "telephone_number": "813-974-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEOS",
        "first_name": "GERELLA",
        "credential": "ITDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-26",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014728000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GERELLA",
            "last_name": "KENNISTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabriel Mateo
• Jocelyn Alexa Mateo
• David Mateos
• Maternal Child Health Coalition
• Grace Leah Mathai
• Jacques Mather, M.D.
• Pam A Matheson
• Tara Ann Matheus
• Abraham Mathew, DDS
• Amy Mathew, M.D.

• Developmental Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.