Gary Nunnally, LCSW, DMIN

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34002418A Issued in IN

Practice address

8202 Clearvista Pkwy
BLDG 7
Indianapolis, IN 46256-1400

Phone

(317) 288-9942

Fax

(317) 288-9945

NPI assigned

Dec 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Buckingham and Associates PC

  • Mental Health Counselor
  • Indianapolis, IN
  • NPI 1588617138
  Medicare reassignment NPD
• Indiana Health Group Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carmel, IN
  • NPI 1356396295

  Clinical

  NPD (past)
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent Pharmacy

  • Community/Retail Pharmacy
  • Indianapolis, IN
  • NPI 1194929646
  NPD (past)
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent Stress Center

  • Psychiatry Physician
  • Indianapolis, IN
  • NPI 1689869893
  NPD (past)

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1205810090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8202 CLEARVISTA PKWY",
            "address_2": "BLDG 7",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561400",
            "telephone_number": "317-288-9942",
            "fax_number": "317-288-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 CLEARVISTA PKWY",
            "address_2": "BLDG 7",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561400",
            "telephone_number": "317-288-9942",
            "fax_number": "317-288-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNNALLY",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "LCSW, DMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34002418A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34002418A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100381890",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luis Orlando Nunez, MD
• Rachel Thelen Nunez, PA-C
• Brian Edward Nunley, D.D.S.
• Camishe R Nunley, LMHC
• Breannah Nunn
• Irene Nunuk, M.D.
• Barbara Ann Nurczyk
• Halkawt Ali Nuri, M.D.
• John I Nurnberger Jr., M.D.
• Nurse Betty Home Health Agency LLC

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.