Individual provider Active NPI

Tim J Gienger, LICSW

  • Clinical Social Worker
  • Bismarck, ND
National Provider Identifier
1245291525
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3637 Issued in ND
Practice address
1237 W Divide Ave
Ste 5
Bismarck, ND 58501-1208
Phone
(701) 328-8888
Fax
(701) 328-8900
NPI assigned
Mar 28, 2006
Last updated
May 13, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

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 3637 ND Primary

Addresses

Primary practice location

1237 W Divide Ave
Ste 5
Bismarck, ND 58501-1208

Mailing address

1237 W Divide Ave
Ste 5
Bismarck, ND 58501-1208
Phone (701) 328-8888

Other identifiers 2

IdentifierTypeStateIssuer
19161MedicaidND
26592OtherNDBLUE CROSS BLUE SHIELD ND

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060113000653 ND Practitioner - Clinical Social Worker 1456374644 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dakota Family Services Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242172800000",
    "number": "1245291525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE",
            "address_2": "STE 5",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011208",
            "telephone_number": "701-328-8888",
            "fax_number": "701-328-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE",
            "address_2": "STE 5",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011208",
            "telephone_number": "701-328-8888",
            "fax_number": "701-328-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIENGER",
        "first_name": "TIM",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2009-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "3637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19161",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ND",
            "identifier": "26592",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.