Micheal G Gore, MSSA, MSW, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6773 Issued in SC

Practice address

130 Broad St
Sumter, SC 29150-4237

Phone

(803) 467-1263

Fax

(803) 774-4378

NPI assigned

Apr 8, 2016

Last updated

Jan 9, 2017By the provider in NPPES

Sex

Male

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 SC

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Envision Wellness Medical Group LLC

  • Child & Adolescent Psychiatry Physician
  • Columbia, SC
  • NPI 1043832157
  Medicare reassignment NPD
• Carolina Behavioral Health Services

  • Community/Behavioral Health Agency
  • Sumter, SC
  • NPI 1093258444
  Authorized official Same address or phone

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1427412162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BROAD ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504237",
            "telephone_number": "803-467-1263",
            "fax_number": "803-774-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BROAD ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504237",
            "telephone_number": "803-467-1263",
            "fax_number": "803-774-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "MICHEAL",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "MSSA, MSW, LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-08",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "6773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Gooch, MCD, CCC-SLP
• Good Samaritan Way
• Angela V Goode
• James A Goodson III, M.D.
• James Arthur Goodson IV, DMD
• Meaghan Hall Gosma, CPNP-PC
• Got Motion Transportation LLC
• Claudia M Graber, RPT
• Grace Kept LLC
• Graceful Pathways LLC

• Clinical Social Worker in Sumter, SC
• Providers in Sumter, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.