Jeffrey Gaudreau

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

630 Issued in OK

Practice address

215 Fairgrounds Rd
Guthrie, OK 73044-4761

Phone

(405) 697-6237

Fax

(405) 282-5389

NPI assigned

Apr 14, 2017

Last updated

Apr 14, 2017By the provider in NPPES

Sex

Male

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

State licenses

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1689108870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 FAIRGROUNDS RD",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730444761",
            "telephone_number": "405-697-6237",
            "fax_number": "405-282-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 FAIRGROUNDS RD",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730444761",
            "telephone_number": "405-697-6237",
            "fax_number": "405-282-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUDREAU",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Guthrie, OK
• Providers in Guthrie, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.

Verify at the official NPI Registry.