Individual provider Active NPI

Chad L Gerhart, PSY.D.

  • Clinical Psychologist
  • Joplin, MO
National Provider Identifier
1386767960
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2006034114 Issued in MO
Practice address
714 S Highland Ave
Joplin, MO 64801-5209
Phone
(417) 624-4475
Fax
(417) 624-4540
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2006034114 MO Primary
Health Service Psychologist 103TH0100X 2006034114 MO

Addresses

Primary practice location

714 S Highland Ave
Joplin, MO 64801-5209

Mailing address

714 S Highland Ave
Joplin, MO 64801-5209
Phone (417) 624-4475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20070629000419 MO Practitioner - Clinical Psychologist 1557460672 Practice locations: Joplin, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

714 S Highland Ave
Joplin, MO 64801-5209
Phone (417) 624-4475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006034114MOMDHealth Service Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1386767960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 S HIGHLAND AVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648015209",
            "telephone_number": "417-624-4475",
            "fax_number": "417-624-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 S HIGHLAND AVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648015209",
            "telephone_number": "417-624-4475",
            "fax_number": "417-624-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERHART",
        "first_name": "CHAD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2006034114",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MO",
            "license": "2006034114",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.