Jacquelyn Gouge, M.S., CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1102 Winkler Ave
Killeen, TX 76542-6249

Phone

(254) 634-8505

Fax

(254) 681-0505

NPI assigned

Jul 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Barr Physical Therapy, P.C.

  • Pediatric Physical Therapist
  • Killeen, TX
  • NPI 1306927553

  Speech-Language Pathologist

  Medicare reassignment NPD
• Barr Physical Therapy, P.C.

  • Speech-Language Pathologist
  • Killeen, TX
  • NPI 1063769685
  NPD (past)
• Reeves Rehab

  • Speech-Language Pathologist
  • San Angelo, TX
  • NPI 1255608766
  NPD (past)
• Reeves Rehab

  • Speech-Language Pathologist
  • San Angelo, TX
  • NPI 1396297776
  NPD (past)
• San Luis Walk-in Clinic, Inc.

  • Rural Health Clinic/Center
  • Somerton, AZ
  • NPI 1003991506
  NPD (past)

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1962886234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 WINKLER AVE",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765426249",
            "telephone_number": "254-634-8505",
            "fax_number": "254-781-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 WINKLER AVE",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765426249",
            "telephone_number": "254-634-8505",
            "fax_number": "254-681-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGE",
        "first_name": "JACQUELYN",
        "credential": "M.S., CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Terri Denise Gossett, NCC, LPC
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• Meagan Carri Graham
• Patricia R Graham, SLP
• Keri Grandalski
• Racent Grant, BCBA

• Speech-Language Pathologist in Killeen, TX
• Providers in Killeen, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.