Gavin Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1729 Issued in NH

Practice address

15 Ermer Rd
Suite # 215
Salem, NH 03079-1271

Phone

(603) 890-6767

Fax

(603) 893-6767

NPI assigned

Apr 16, 2015

Sex

Male

Sole proprietor

Yes

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

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1023405115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ERMER RD",
            "address_2": "SUITE # 215",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030791271",
            "telephone_number": "603-890-6767",
            "fax_number": "603-893-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ERMER RD",
            "address_2": "SUITE # 215",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030791271",
            "telephone_number": "603-890-6767",
            "fax_number": "603-893-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GAVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Siriann, SLP
• Jacqueline Sison
• Krystal Gaidis Small, OTR/L
• Callie Lynne Smith, MS OTR/L
• Christine E Smith, DPT
• Samantha Smith
• Nancy M Soldano
• Barbara Solimine, PT
• Kim Solso
• Kristin Soucy, PT

• Clinical Social Worker in Salem, NH
• Providers in Salem, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.