Molly A Gannon, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1408 Issued in WI

Practice address

3360 Gateway Rd Ste 100
Brookfield, WI 53045-5115

Phone

(262) 923-7101

NPI assigned

Jan 29, 2007

Last updated

Apr 30, 2024By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Greenfield Rehabilitation Agency, Inc.

  dba Rehab Resources

  • Physical Therapist
  • Brookfield, WI
  • NPI 1790230571

  Speech-Language Pathologist

  NPD
• Greenfield Rehabilitation Agency, Inc.

  • Physical Therapist
  • Brookfield, WI
  • NPI 1811907462

  Speech-Language Pathologist

  NPD
• Valley-Bay Therapy Inc.

  • Specialist
  • Appleton, WI
  • NPI 1720138514

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1659417616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 FOX FIRE DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549046558",
            "telephone_number": "920-426-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 GATEWAY RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455115",
            "telephone_number": "262-923-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "MOLLY",
        "middle_name": "A",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42754200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Paola Galindo, M.D.
• Sarah A Gall, RN
• Galleria West Dental S.C.
• Jenna Galusha
• Lisa R Gamble, OTR
• Mary L. Ganz, D.O.
• Ashley Garcia
• James C Gariti, MD
• Amanda Gaska, DPT
• Samantha Gates, BCBA

• Speech-Language Pathologist in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.