NPIMap

Organization Active NPI

Jesse Gorley, M.D., PLLC

  • Psychiatry Physician
  • Wichita Falls, TX
National Provider Identifier
1164083010
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
JESSE GORLEY, M.D., PLLC
Practice address
1411 9TH St.
Wichita Falls, TX 76301-4302
Phone
(940) 386-9041
Fax
(940) 448-3298
NPI assigned
Jun 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Jesse David Gorley, M.D.NPI 1346452760
Title
President
Phone
(940) 386-9041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1411 9TH St.
Wichita Falls, TX 76301-4302

Mailing address

1411 9TH St.
Wichita Falls, TX 76301-4302
Phone (940) 386-9041

Other identifiers 2

IdentifierTypeStateIssuer
M9322OtherTXTEXAS MEDICAL BOARD
1346452760MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190912002376 TX Part B Supplier - Clinic/Group Practice 6204165442 Receives reassigned benefits from 6 practitioners
Practice locations: Wichita Falls, TX

National Provider Directory

National Provider Directory

Locations

1411 9th St
Wichita Falls, TX 76301
Phone (940) 247-0338

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1164083010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 9TH ST.",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014302",
            "telephone_number": "940-386-9041",
            "fax_number": "940-448-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 9TH ST.",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014302",
            "telephone_number": "940-386-9041",
            "fax_number": "940-448-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSE GORLEY, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-21",
        "last_updated": "2023-03-07",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "GORLEY",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-386-9041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "M9322",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346452760",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.