Individual provider Active NPI

Kayla Justine Gilman

  • Social Worker
  • Redford, MI
National Provider Identifier
1386151629
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801102977 Issued in MI
Practice address
9315 Telegraph Rd
Redford, MI 48239-1260
Phone
(313) 450-4500
NPI assigned
Jan 9, 2018
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6851102977 MI
Social Worker 104100000X 6801102977 MI Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

9315 Telegraph Rd
Redford, MI 48239-1260

Mailing address

402 Ramsey Rd
Yardley, PA 19067-4664
Phone (734) 612-5493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, PA2 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

Enrollment IDStateProvider typePAC IDDetails
I20250115000809 MI Practitioner - Clinical Social Worker 2264960574 Reassigns benefits to 1 organization
I20250116003627 PA Practitioner - Clinical Social Worker 2264960574 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801102977MIMDSocial Worker
6851102977MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Dec 17, 2024 Accepting new patients
Richard Kneip, PH.D., P.C. Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1386151629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 RAMSEY RD",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190674664",
            "telephone_number": "734-612-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9315 TELEGRAPH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391260",
            "telephone_number": "313-450-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMAN",
        "first_name": "KAYLA",
        "middle_name": "JUSTINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851102977",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801102977",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

Verify at the official NPI Registry.