Active NPI
Gillian Mary Stavro, PH.D.
- Clinical Neuropsychologist
- Baltimore, MD
National Provider Identifier
1518353382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 04623
- Practice address
- 5051 Greenspring Ave Ste 200
Baltimore, MD 21209-4357 - Phone
- (410) 601-7375
- NPI assigned
- Apr 8, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 04623 | MD | Primary |
Addresses
Primary practice location
5051 Greenspring Ave Ste 200
Baltimore, MD 21209-4357
Mailing address
217 Whitmoor Ter
Silver Spring, MD 20901-1522
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04623 | MD | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428451200000",
"number": "1518353382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 WHITMOOR TER",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209011522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5051 GREENSPRING AVE STE 200",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212094357",
"telephone_number": "410-601-7375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAVRO",
"first_name": "GILLIAN",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-08",
"last_updated": "2015-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MD",
"license": "04623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.