Individual provider Active NPI

Anthony John Gage III, LCSW

  • Clinical Social Worker
  • Wytheville, VA
National Provider Identifier
1124200498
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006193 Issued in VA
Practice address
320 W Ridge Rd
Wytheville, VA 24382-1009
Phone
(276) 228-8775
NPI assigned
Nov 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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 0904006193 VA Primary

Addresses

Primary practice location

320 W Ridge Rd
Wytheville, VA 24382-1009

Mailing address

320 W Ridge Rd
Wytheville, VA 24382-1009
Phone (276) 228-8775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201030001744 VA Practitioner - Clinical Social Worker 1658781760 Reassigns benefits to 1 organization
I20230130000848 DC Practitioner - Clinical Social Worker 1658781760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neuropsych Wellness Center, PCGroup PAC ID 9335271725, 22 clinicians

Practice addresses (Care Compare)

3930 Pender Dr
Suite 240
Fairfax, VA 22030-0986
Phone (703) 865-8686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904006193VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Behavioral Health Clinical CurrentSince Jun 16, 2021 Accepting new patients
Neuropsych Wellness Center, PC CurrentSince Jan 16, 2023 Accepting new patients
Infinity Counseling Center, LLC Past Accepting new patients

Locations

143 Industrial Pkwy
Clarksville, VA 23927
Phone (434) 572-6916

3930 Pender Dr
Ste 350
Fairfax, VA 22030
Phone (703) 865-6565

3930 Pender Dr
Ste 240
Fairfax, VA 22030
Phone (703) 865-8686

424 Hamilton Blvd
South Boston, VA 24592
Phone (434) 572-2936

Organizations & group practices 3

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": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1124200498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W RIDGE RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821009",
            "telephone_number": "276-228-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W RIDGE RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821009",
            "telephone_number": "276-228-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGE",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

Verify at the official NPI Registry.