Brian Gary, SOCIAL WORK

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

216 Park Ave NW
PO Box X
Bagley, MN 56621-9500

Phone

(218) 694-6164

Fax

(218) 694-3535

NPI assigned

Aug 24, 2011

Last updated

Aug 24, 2011By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Clearwater County Department of Human Services

  • Case Management Agency
  • Bagley, MN
  • NPI 1700331576
  NPD (past)
• Upper Mississippi Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Bemidji, MN
  • NPI 1083717334
  NPD (past)

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1346520145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 PARK AVE NW",
            "address_2": "PO BOX X",
            "city": "BAGLEY",
            "state": "MN",
            "postal_code": "566219500",
            "telephone_number": "218-694-6164",
            "fax_number": "218-694-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 PARK AVE NW",
            "address_2": "PO BOX X",
            "city": "BAGLEY",
            "state": "MN",
            "postal_code": "566219500",
            "telephone_number": "218-694-6164",
            "fax_number": "218-694-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARY",
        "first_name": "BRIAN",
        "credential": "SOCIAL WORK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SERVICES",
            "identifier": "27",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter A Eriksson, MD
• Kathryn Falk, OTR/L
• Katie Rose Ferry Olson
• First Care Medical Services (Essentia Health Bagley Clinic)
• David Andrew Galloway, D.C.
• Isabelle Grover
• Daniel Hagerty, NP
• Tammy Rae Hanse, RN
• Janet Rene Haugen
• Sarah Heider, DPT

• Social Worker in Bagley, MN
• Providers in Bagley, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.