Individual provider Active NPI

Alexander K Gerry, PLPC

  • Professional Counselor
  • Bolivar, MO
National Provider Identifier
1104775493
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2026016280 Issued in MO
Practice address
315 S Main Ave
Bolivar, MO 65613-2052
Phone
(417) 761-5920
Fax
(417) 761-5921
NPI assigned
Jan 28, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2026016280 MO Primary

Addresses

Primary practice location

315 S Main Ave
Bolivar, MO 65613-2052

Mailing address

PO Box 844715
Kansas City, MO 64184-4715
Phone (417) 761-5214

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

LicenseStateTypeSpecialty
2026016280MOMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1769558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1104775493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844715",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641844715",
            "telephone_number": "417-761-5214",
            "fax_number": "417-761-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MAIN AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656132052",
            "telephone_number": "417-761-5920",
            "fax_number": "417-761-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERRY",
        "first_name": "ALEXANDER",
        "middle_name": "K",
        "credential": "PLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2026016280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.