Erica Jex Gergely

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301015111 Issued in MI

Practice address

5340 Holiday Ter
Kalamazoo, MI 49009-2196

Phone

(269) 372-4140

Fax

(269) 372-0390

NPI assigned

Nov 6, 2012

Last updated

Nov 29, 2018By the provider in NPPES

Sex

Female

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)

Enrolled

State licenses

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1407100894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 HOLIDAY TER",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092196",
            "telephone_number": "269-372-4140",
            "fax_number": "269-372-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 HOLIDAY TER",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092196",
            "telephone_number": "269-372-4140",
            "fax_number": "269-372-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERGELY",
        "first_name": "ERICA",
        "middle_name": "JEX",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301015111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "6301015111",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Gentry, MA
• George C Whitaker MD PC (Midwest Eye Care)
• George L. Namay, D.D.S. Forest Dental, Mi PLLC
• Thomas M. George, MD
• Alida Geppert, MA LPC
• Robert Raymond Gerl, D. MIN., PH.D.
• David Germaine
• Megan Janay Gest, MD
• Mekasha Mikael Getachew, MD
• Lauren Gevaart

• Psychologist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.