Individual provider Active NPI

Philip Mark Gamber, MSW

  • Clinical Social Worker
  • East Lansing, MI
National Provider Identifier
1487662474
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801070603 Issued in MI
Practice address
5000 Northwind Dr
Suite 100
East Lansing, MI 48823-5044
Phone
(517) 505-0610
Fax
(517) 853-2003
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801070603 MI Primary

Addresses

Primary practice location

5000 Northwind Dr
Suite 100
East Lansing, MI 48823-5044

Mailing address

PO Box 23113
Lansing, MI 48909-3113
Phone (517) 505-0610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040514000402 MI Practitioner - Clinical Social Worker 4082604830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Counseling Services LLCGroup PAC ID 0749382430, 3 clinicians

Practice addresses (Care Compare)

2840 E Grand River Ave
Suite 5
East Lansing, MI 48823-6731
Phone (517) 505-0610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mareck Family and Geriatric Services, P.C. Clinical PastSince Jan 1, 2004 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1487662474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23113",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489093113",
            "telephone_number": "517-505-0610",
            "fax_number": "517-853-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 NORTHWIND DR",
            "address_2": "SUITE 100",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235044",
            "telephone_number": "517-505-0610",
            "fax_number": "517-853-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBER",
        "first_name": "PHILIP",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801070603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.