Individual provider Active NPI

Gilbert Tetteh Tamakloe, MD

  • Psychiatry Physician
  • Longwood, FL
National Provider Identifier
1528012200
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME75987 Issued in FL
Practice address
455 W. Warren Ave.
Longwood, FL 32750-4002
Phone
(407) 262-2220
Fax
(407) 834-5011
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME75987 FL Primary

Addresses

Primary practice location

455 W. Warren Ave.
Longwood, FL 32750-4002

Mailing address

455 W. Warren Ave.
Longwood, FL 32750-4002
Phone (407) 262-2220

Other identifiers 4

IdentifierTypeStateIssuer
P00187735OtherRAILRAOD MEDICARE
ME75987OtherFLMEDICAL LICENSE
271131100MedicaidFL
50412OtherFLBCBS

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 Medicine

State licenses

LicenseStateTypeSpecialty
ME75987FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Behavioral Care Past Accepting new patients
Carolina Behavioral Care, P.a. Psychiatry Past 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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1528012200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 W. WARREN AVE.",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504002",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W. WARREN AVE.",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504002",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAKLOE",
        "first_name": "GILBERT",
        "middle_name": "TETTEH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME75987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAOD MEDICARE",
            "identifier": "P00187735",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME75987",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271131100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "50412",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.