Renita Shores-Gaston, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017848 Issued in IL

Practice address

5844 Elaine Dr Ste 101
Rockford, IL 61108-2494

Phone

(815) 373-3027

NPI assigned

Nov 30, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, AZ2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Renita Shores-GastonGroup PAC ID 0941614705, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Renita Shores-Gaston

  • Clinical Social Worker
  • Rockford, IL
  • NPI 1518421577

  AZ

  Medicare reassignment Care Compare group NPD Authorized official
• Linda Nguyen

  • Marriage & Family Therapist
  • Rockford, IL
  • NPI 1710791439
  NPD

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1346614435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5844 ELAINE DR STE 101",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082494",
            "telephone_number": "815-373-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5844 ELAINE DR STE 101",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082494",
            "telephone_number": "815-373-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORES-GASTON",
        "first_name": "RENITA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-30",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman E Shirk Jr., LCPC
• David S Shoberg, M.D.
• William G Shold, DDS
• Margaret Ruth Shook, COTA/L
• Shoptikal LLC
• De'Shace Short
• Karen L. Short, LCSW
• Kristi L Showalter, FNP-BC
• Sujit Prasad Shrestha, M.D.
• Autumn Shreve

• Clinical Social Worker in Rockford, IL
• Providers in Rockford, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.