Individual provider Active NPI

Christine Angela Gephart, LCSW-R

  • Clinical Social Worker
  • Le Roy, NY
National Provider Identifier
1528280757
Registry record updated Feb 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R055014-1 Issued in NY
Practice address
71 Main St
Le Roy, NY 14482-1444
Phone
(585) 502-6025
Fax
(585) 502-5213
NPI assigned
May 3, 2007
Last updated
Feb 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2018

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 R055014-1 NY Primary

Addresses

Primary practice location

71 Main St
Le Roy, NY 14482-1444

Mailing address

71 Main St
Le Roy, NY 14482-1444
Phone (585) 502-6025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20181227000102 NY Practitioner - Clinical Social Worker 8527303601 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R055014-1NYMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518652800000",
    "number": "1528280757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 MAIN ST",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144821444",
            "telephone_number": "585-502-6025",
            "fax_number": "585-502-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 MAIN ST",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144821444",
            "telephone_number": "585-502-6025",
            "fax_number": "585-502-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEPHART",
        "first_name": "CHRISTINE",
        "middle_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2018-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R055014-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Roy, NY

Sources for this page

Verify at the official NPI Registry.