Active NPI
Gary Gerst, PA-C
- Medical Physician Assistant
- Ina, IL
National Provider Identifier
1154727923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 085.001255
- Practice address
- 251 North Illinois Highway 37
Ina, IL 62846 - Phone
- (618) 437-5300
- NPI assigned
- Nov 6, 2014
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085.001255 | IL | Primary |
Addresses
Primary practice location
251 North Illinois Highway 37
Ina, IL 62846
Mailing address
P.O. Box 1000
251 North Illinois Highway 37
Ina, IL 62846
Phone (618) 437-5300
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
| License | State | Type | Specialty |
|---|---|---|---|
| 085.001255 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson County | Past | Accepting new patients |
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.
-
- Public Health or Welfare Agency
- Mount Vernon, IL
- NPI 1235253907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415232000000",
"number": "1154727923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1000",
"address_2": "251 NORTH ILLINOIS HIGHWAY 37",
"city": "INA",
"state": "IL",
"postal_code": "62846",
"telephone_number": "618-437-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 NORTH ILLINOIS HIGHWAY 37",
"city": "INA",
"state": "IL",
"postal_code": "62846",
"telephone_number": "618-437-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERST",
"first_name": "GARY",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-06",
"last_updated": "2014-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085.001255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ina, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.