Individual provider Active NPI

Pamela Patricia Gerdes, LISW

  • Clinical Social Worker
  • Mason, OH
National Provider Identifier
1073836441
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0900254 Issued in OH
Practice address
7577 Central Parke Blvd
Mason, OH 45040-6810
Phone
(513) 770-3231
Fax
(513) 770-5541
NPI assigned
Mar 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I0900254 OH Primary

Addresses

Primary practice location

7577 Central Parke Blvd
Mason, OH 45040-6810

Mailing address

6583 Carriage Hill LN
Cincinnati, OH 45243-2450
Phone (513) 659-4852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20140106000113 OH Practitioner - Clinical Social Worker 2668600271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Cincinnati College of Medicine, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Lifeway Counseling Centers IncGroup PAC ID 8729036033, 12 clinicians

Practice addresses (Care Compare)

11161 Kenwood Rd
Blue Ash, OH 45242-1817
Phone (513) 769-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0900254OHMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1073836441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6583 CARRIAGE HILL LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452432450",
            "telephone_number": "513-659-4852",
            "fax_number": "513-451-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7577 CENTRAL PARKE BLVD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450406810",
            "telephone_number": "513-770-3231",
            "fax_number": "513-770-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERDES",
        "first_name": "PAMELA",
        "middle_name": "PATRICIA",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0900254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.