Active NPI
Gina Baron Gough, OTR/L
- Occupational Therapist
- Raleigh, NC
National Provider Identifier
1598275232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 10083
- Practice address
- 5920 Sandy Forks Rd Ste 200
Raleigh, NC 27609-3814 - Phone
- (919) 954-3492
- Fax
- (919) 954-3947
- NPI assigned
- Oct 9, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 10083 | NC | Primary |
Addresses
Primary practice location
5920 Sandy Forks Rd Ste 200
Raleigh, NC 27609-3814
Mailing address
5920 Sandy Forks Rd Ste 200
Raleigh, NC 27609-3814
Phone (919) 954-3492
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10083 | NC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507507200000",
"number": "1598275232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5920 SANDY FORKS RD STE 200",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276093814",
"telephone_number": "919-954-3492",
"fax_number": "919-954-3947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5920 SANDY FORKS RD STE 200",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276093814",
"telephone_number": "919-954-3492",
"fax_number": "919-954-3947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOUGH",
"first_name": "GINA",
"middle_name": "BARON",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-09",
"last_updated": "2017-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "10083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.