Active NPI
Gary William Pollitz, LMSW
- Social Worker
- Okemos, MI
National Provider Identifier
1447366398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801035521
- Practice address
- 3493 Woods Edge Dr
Suite 103
Okemos, MI 48864-6030 - Phone
- (517) 886-3707
- Fax
- (517) 349-1973
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801035521 | MI | |
| Social Worker | 104100000X | 6801035521 | MI | Primary |
Addresses
Primary practice location
3493 Woods Edge Dr
Suite 103
Okemos, MI 48864-6030
Mailing address
3493 Woods Edge Dr
Suite 103
Okemos, MI 48864-6030
Phone (517) 886-3707
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0890848 | Other | MI | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801035521 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298505600000",
"number": "1447366398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3493 WOODS EDGE DR",
"address_2": "SUITE 103",
"city": "OKEMOS",
"state": "MI",
"postal_code": "488646030",
"telephone_number": "517-886-3707",
"fax_number": "517-349-1973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3493 WOODS EDGE DR",
"address_2": "SUITE 103",
"city": "OKEMOS",
"state": "MI",
"postal_code": "488646030",
"telephone_number": "517-886-3707",
"fax_number": "517-349-1973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLITZ",
"first_name": "GARY",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2011-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801035521",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801035521",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0890848",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Okemos, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.