Individual provider Active NPI

Gail D Guillory, LCSW

  • Clinical Social Worker
  • Jupiter, FL
National Provider Identifier
1336122464
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW4347 Issued in FL
Practice address
4425 Military TRL Ste 203
Jupiter, FL 33458-4817
Phone
(561) 747-2775
Fax
(561) 747-1881
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4347 FL
Clinical Social Worker 1041C0700X SW4347 FL Primary

Addresses

Primary practice location

4425 Military TRL Ste 203
Jupiter, FL 33458-4817

Mailing address

4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Phone (239) 223-2751

Other practice location 1

1851 W Indiantown Rd
Suite 102
Jupiter, FL 33458-3995
Phone (561) 747-2775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080922000274 FL Practitioner - Clinical Social Worker 9931273109 Reassigns benefits to 1 organization
Practice locations: Jupiter, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4425 Military TRL
Suite 203
Jupiter, FL 33458-4817
Phone (239) 223-2751

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4347FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita Springs Retirement Village, Inc. CurrentSince Jan 31, 2022 Accepting new patients
Dna Comprehensive Therapy Services, LLC Clinical CurrentSince Jan 31, 2022 Accepting new patients
Family Counseling Associates, Inc. PastSince Jan 1, 1990 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

4425 Military Trl
Ste 203
Jupiter, FL 33458
Phone (561) 747-2775

Interoperability endpoints

  • Direct secure messaging: gail.guillory.1@13142.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1336122464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-223-2751",
            "fax_number": "239-561-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 MILITARY TRL STE 203",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584817",
            "telephone_number": "561-747-2775",
            "fax_number": "561-747-1881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1851 W Indiantown Rd",
            "address_2": "SUITE 102",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334583995",
            "country_code": "US",
            "telephone_number": "561-747-2775",
            "fax_number": "561-747-1881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUILLORY",
        "first_name": "GAIL",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "4347",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.