Bethany Harrelson Gough, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S3346 Issued in MS

Practice address

950 E County Line Rd
Suite E
Ridgeland, MS 39157-1928

Phone

(601) 853-9747

Fax

(601) 898-4761

NPI assigned

Apr 12, 2010

Last updated

Sep 22, 2015By 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

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Louisville, MS
  • NPI 1952732448
  Medicare reassignment
• Drayer Physical Therapy Institute LLC

  dba Rehab At Work

  • Physical Therapist
  • Columbus, MS
  • NPI 1073859807
  NPD (past)
• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Crystal Springs, MS
  • NPI 1801333521
  NPD (past)

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1871819177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD",
            "address_2": "SUITE E",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-853-9747",
            "fax_number": "601-898-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD",
            "address_2": "SUITE E",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-853-9747",
            "fax_number": "601-898-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGH",
        "first_name": "BETHANY",
        "middle_name": "HARRELSON",
        "name_prefix": "Mrs.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-12",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Gooden, FNP-C
• Diane V. Goodloe, OT
• Brian Heath Gordon, PHD
• Courtney Rae Gordon, NP
• Phoebe Gordon, MT
• Gptrs II (Genesis Physical Therapy and Rehabilitation Services LLC)
• Gptrs II (Genesis Physical Therapy and Rehabilitation Services)
• Gptrs II (Genesis Physical Therapy and Rehabilitation Services)
• Grace and Mercy Health Care Services,LLC
• Grace Independent Living Store, LLC

• Speech-Language Pathologist in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.