Active NPI
Anita B Gantner, PH.D
- Rehabilitation Psychologist
- Cleveland, OH
National Provider Identifier
1053342840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Psychologist
- License
- 4399
- Practice address
- 2500 Metrohealth Dr
MHMC-PM&R
Cleveland, OH 44109-1900 - Phone
- (216) 778-7799
- NPI assigned
- Jul 6, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Rehabilitation Psychologist | 103TR0400X | 4399 | OH | Primary |
Addresses
Primary practice location
2500 Metrohealth Dr
MHMC-PM&R
Cleveland, OH 44109-1900
Mailing address
2500 Metrohealth Dr
MHMC-PM&R
Cleveland, OH 44109-1900
Phone (216) 778-7799
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2726468400 | Other | OH | BWC |
| 0861385 | Medicaid | OH |
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 |
|---|---|---|---|
| 4399 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053342840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 METROHEALTH DR",
"address_2": "MHMC-PM&R",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441091900",
"telephone_number": "216-778-7799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 METROHEALTH DR",
"address_2": "MHMC-PM&R",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441091900",
"telephone_number": "216-778-7799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANTNER",
"first_name": "ANITA",
"middle_name": "B",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "OH",
"license": "4399",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BWC",
"identifier": "2726468400",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0861385",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.