Darrin Gourlay, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901016366 Issued in MI

Practice address

104 Grant St
Niles, MI 49120-2201

Phone

(269) 683-1077

NPI assigned

Oct 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316028046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 GRANT ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202201",
            "telephone_number": "269-683-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GRANT ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202201",
            "telephone_number": "269-683-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURLAY",
        "first_name": "DARRIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4498481",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• GLC Home Health Swmi LLC (Elara Caring)
• Glenda M Gensolin MD PLLC
• Antonio Ray Gonzales, D.C.
• Emma Goodling
• Jill L Gorsuch, DO, MPH
• Greater Niles Cardiology PC
• Greater Niles Chiropractic Health Center Incorporated
• Yvette Yolanda Greene
• Carrie Lynn Grellmann, RPT
• Taiyler Griffin

• General Practice Dentistry in Niles, MI
• Providers in Niles, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.