Andrea Gollegly

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1673 Mason Ave
Daytona Beach, FL 32117-5515

Phone

(386) 944-7813

Fax

(386) 252-3403

NPI assigned

Jun 12, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: agollegly@esnecfl.org

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1750940722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 DUNN AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142405",
            "telephone_number": "386-944-7813",
            "fax_number": "386-252-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1673 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175515",
            "telephone_number": "386-944-7813",
            "fax_number": "386-252-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLEGLY",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AGOLLEGLY@ESNECFL.ORG",
            "affiliation": "N",
            "address_1": "1219 Dunn Ave",
            "city": "Daytona Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321142405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharon Noble Goldish, M.D.
• Harry J Goldschein, DDS
• Alan Scott Goldsmith, MD
• Adam Kenneth Golias, PMHNP-BC, RN
• Radharani S. Gollamudi, M.D.
• Sarah Gollubier
• Loren Ebrada Gomes, APRN
• Mayra E Gomez
• Tiffany A Gommel, MSW, RCSWI
• Gonstead Chiropractic Clinic of East Florida LLC

• Social Worker in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.