Taylor Marie Gerdeman

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

UJ637563 Issued in OH

Practice address

600 Thimble Shoals Blvd Ste 110
Newport News, VA 23606-2768

Phone

(757) 690-9390

NPI assigned

Dec 16, 2020

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

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": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1922694645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 WATERS EDGE DR APT J",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 THIMBLE SHOALS BLVD STE 110",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062768",
            "telephone_number": "757-690-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERDEMAN",
        "first_name": "TAYLOR",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OH",
            "license": "UJ637563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Venisse A Georgalas, D.C.
• George G Childs MD PC
• John George, M.D.
• Nifliyah George
• Gerald Q. Freeman Jr., DDS LLC (a division of Atlantic Dental Care)
• Frederick Martin Gessner, MD
• Patricia Lee Geyer Wessler, MD
• Raouf Samir Gharbo, DO
• Michaela Ghassemi
• Sudip Ghimire, MD

• Behavior Technician in Newport News, VA
• Providers in Newport News, VA by specialty
• Behavior Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.