Individual provider Active NPI

Helen J Gormley-Guttu

  • Occupational Therapist
  • Mount Vernon, WA
National Provider Identifier
1912167354
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056000835 Issued in IL
Practice address
16177 Mountain View Rd
Mount Vernon, WA 98274-7004
Phone
(360) 941-0164
NPI assigned
Jun 10, 2008
Last updated
Jan 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT00001867 WA
Occupational Therapist 225X00000X 056000835 IL Primary

Addresses

Primary practice location

16177 Mountain View Rd
Mount Vernon, WA 98274-7004

Mailing address

16177 Mountain View Rd
Mount Vernon, WA 98274-7004
Phone (360) 941-0164

Other names 1

  • Ms. Holly Gormley-Guttu Professional name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
056000835ILMDOccupational Therapist
OT00001867WAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1912167354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16177 MOUNTAIN VIEW RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982747004",
            "telephone_number": "360-941-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16177 MOUNTAIN VIEW RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982747004",
            "telephone_number": "360-941-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMLEY-GUTTU",
        "first_name": "HELEN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00001867",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056000835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "GORMLEY-GUTTU",
            "prefix": "MS.",
            "credential": "MED., OTR/L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.