Active NPI
David W Gnewikow, PH.D.
- Audiologist
- Mount Juliet, TN
National Provider Identifier
1053465377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 1262
- Practice address
- 1002 Pleasant Grove PL Ste C
Mount Juliet, TN 37122-1501 - Phone
- (615) 406-0500
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1262 | TN | Primary |
Addresses
Primary practice location
1002 Pleasant Grove PL Ste C
Mount Juliet, TN 37122-1501
Mailing address
404 Laurel Hills Dr
Mount Juliet, TN 37122-8406
Phone (615) 758-4901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070712000796 | TN | Practitioner - Qualified Audiologist | 5597865097 | Practice locations: Mount Juliet, TN |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Vanderbilt University School of Medicine, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
820 N Mount Juliet Rd
Suite 200
Mount Juliet, TN 37122-3391
Phone (615) 758-7999
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1262 | TN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053465377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 LAUREL HILLS DR",
"city": "MOUNT JULIET",
"state": "TN",
"postal_code": "371228406",
"telephone_number": "615-758-4901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 PLEASANT GROVE PL STE C",
"city": "MOUNT JULIET",
"state": "TN",
"postal_code": "371221501",
"telephone_number": "615-406-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GNEWIKOW",
"first_name": "DAVID",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TN",
"license": "1262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Juliet, TN
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.