Active NPI
John Ralph Gielow, PSYD
- Psychologist
- Milwaukee, WI
National Provider Identifier
1558477638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1369
- Practice address
- 827 N Cass St
Milwaukee, WI 53202-3908 - Phone
- (414) 278-7980
- Fax
- (414) 278-8299
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1369 | WI | Primary |
Addresses
Primary practice location
827 N Cass St
Milwaukee, WI 53202-3908
Mailing address
827 N Cass St
Milwaukee, WI 53202-3908
Phone (414) 278-7980
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 391938840017 | Other | WI | BLUE CROSS & COMPCARE |
| 39235700 | Medicaid | WI | |
| 6199225 | Other | WI | UNITED HEALTHCARE |
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 |
|---|---|---|---|
| 1369 | WI | MD | Psychologist |
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": "1183852800000",
"number": "1558477638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "827 N CASS ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532023908",
"telephone_number": "414-278-7980",
"fax_number": "414-278-8299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "827 N CASS ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532023908",
"telephone_number": "414-278-7980",
"fax_number": "414-278-8299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIELOW",
"first_name": "JOHN",
"middle_name": "RALPH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "1369",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & COMPCARE",
"identifier": "391938840017",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39235700",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "6199225",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.