Michael Gershon, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS00171 Issued in RI

Practice address

889 Centerville Rd
Warwick, RI 02886-4342

Phone

(401) 821-4100

Fax

(401) 823-9180

NPI assigned

Mar 22, 2007

Sex

Male

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Child and Family Psychiatry, Inc.

  • Psychiatry Physician
  • Warwick, RI
  • NPI 1760863229
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1437275104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 CUMBERLAND RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028868709",
            "telephone_number": "401-885-4088",
            "fax_number": "401-823-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 CENTERVILLE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864342",
            "telephone_number": "401-821-4100",
            "fax_number": "401-823-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSHON",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS00171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HAELTH PROVIDER #",
            "identifier": "6108438",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CROSS PROVIDER #",
            "identifier": "0000030545",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MG51041",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CHIP PROVIDER #",
            "identifier": "000873",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George J Jacewicz, M. D., Inc
• Gerald W. Glaser, O.D. and Associates, Inc.
• Bettie Gerard, ACSW LICSW
• Gershon Psychological Associates, LLC
• Jonathan Gershon, PHD
• Catherine Rachel Gervais, RN, BSN, CDOE
• Shamim Ghadami, CRNA
• Padideh Ghaeli, PHARMD
• Subul A Ghaffar, MD
• Olivier M Gherardi

• Clinical Psychologist in Warwick, RI
• Providers in Warwick, RI by specialty
• Clinical Psychologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.