Active NPI
Gregory Paul Takala, LBSW
- Social Worker
- Iron River, MI
National Provider Identifier
1023046760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802020410
- Practice address
- 703 N 2ND Ave
Iron River, MI 49935-1451 - Phone
- (906) 265-5126
- Fax
- (906) 265-5878
- NPI assigned
- Jun 29, 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802020410 | MI | Primary |
Addresses
Primary practice location
703 N 2ND Ave
Iron River, MI 49935-1451
Mailing address
715 Pyle Dr
Kingsford, MI 49802-4456
Phone (906) 774-0522
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GT020410 | Other | MI | BCBS OF MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6802020410 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251936000000",
"number": "1023046760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 PYLE DR",
"city": "KINGSFORD",
"state": "MI",
"postal_code": "498024456",
"telephone_number": "906-774-0522",
"fax_number": "906-774-1570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 N 2ND AVE",
"city": "IRON RIVER",
"state": "MI",
"postal_code": "499351451",
"telephone_number": "906-265-5126",
"fax_number": "906-265-5878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAKALA",
"first_name": "GREGORY",
"middle_name": "PAUL",
"credential": "LBSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2009-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802020410",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MI",
"identifier": "GT020410",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Iron River, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.