Individual provider Active NPI

Michelle C Gates

  • Clinical Psychologist
  • Kansas City, MO
National Provider Identifier
1255703971
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2018000612 Issued in MO
Practice address
2301 Holmes St
Kansas City, MO 64108-2640
Phone
(816) 404-4375
Fax
(816) 404-4337
NPI assigned
Oct 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2018000612 MO Primary
Health Psychologist 103TH0004X 071-009144 IL

Addresses

Primary practice location

2301 Holmes St
Kansas City, MO 64108-2640

Mailing address

315 W Carpenter St
PO Box 19677
Springfield, IL 62702-4901
Phone (217) 545-8000

Other practice location 1

315 W Carpenter St
1St Floor, Clinic a
Springfield, IL 62702-4901
Phone (217) 545-8000

Other practice location 2

2101 Charlotte St
Kansas City, MO 64108-2727
Phone (816) 404-1000

Other identifiers 1

IdentifierTypeStateIssuer
490050945MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20180326000927 MO Practitioner - Clinical Psychologist 8325348469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Texas Tech University Health Science Center School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Truman Medical Center Incorporated CurrentSince Mar 23, 2018 Accepting new patients
Truman Medical Center, Incorporated Current Accepting new patients
Truman Medical Center, Incorporated CurrentSince Mar 23, 2018 Accepting new patients

Locations

2301 Holmes St
Kansas City, MO 64108

2301 Holmes St
Fl 5
Kansas City, MO 64108
Phone (816) 404-4270

2101 Charlotte St
Kansas City, MO 64108
Phone (816) 404-0072

300 W 19th Ter
Kansas City, MO 64108
Phone (816) 404-5709

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1255703971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W CARPENTER ST",
            "address_2": "PO BOX 19677",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024901",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HOLMES ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082640",
            "telephone_number": "816-404-4375",
            "fax_number": "816-404-4337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Carpenter St",
            "address_2": "1ST FLOOR, CLINIC A",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627024901",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-0548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 Charlotte St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082727",
            "country_code": "US",
            "telephone_number": "816-404-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GATES",
        "first_name": "MICHELLE",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-21",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2018000612",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "IL",
            "license": "071-009144",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490050945",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.