Active NPI
Gary R. Elkins, P.H.D.
- Clinical Psychologist
- Temple, TX
National Provider Identifier
1003876855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 22520
- Practice address
- 2027 S 61St St
Suite 121
Temple, TX 76504-6867 - Phone
- (254) 778-6922
- Fax
- (254) 778-4332
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 22520 | TX | Primary |
Addresses
Primary practice location
2027 S 61St St
Suite 121
Temple, TX 76504-6867
Mailing address
2027 S 61St St
Suite 121
Temple, TX 76504-6867
Phone (254) 778-6922
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0041NU | Other | TX | BCBS OF TEXAS |
| 1003876855 | Other | AETNA | |
| 1003876855 | Other | MAGELLAN | |
| 1003876855 | Other | TX | SCOTT AND WHITE HEALTH PL |
| 040065701 | Medicaid | TX |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22520 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1003876855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2027 S 61ST ST",
"address_2": "SUITE 121",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765046867",
"telephone_number": "254-778-6922",
"fax_number": "254-778-4332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2027 S 61ST ST",
"address_2": "SUITE 121",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765046867",
"telephone_number": "254-778-6922",
"fax_number": "254-778-4332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELKINS",
"first_name": "GARY",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "P.H.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "22520",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "0041NU",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1003876855",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "1003876855",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SCOTT AND WHITE HEALTH PL",
"identifier": "1003876855",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "040065701",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.