Active NPI
Thomas Wallace Gitchel Jr., STNA, RN
- Registered Nurse
- St Louisville, OH
National Provider Identifier
1558616680
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 18, 2014.
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 377484
- Practice address
- 9470 Hunt Rd
St Louisville, OH 43071-9758 - Phone
- (317) 695-0153
- NPI assigned
- Jul 15, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 377484 | OH | Primary |
| Nurse's Aide | 376K00000X | 400929290609 | OH |
Addresses
Primary practice location
9470 Hunt Rd
St Louisville, OH 43071-9758
Mailing address
9470 Hunt Rd
St Louisville, OH 43071-9758
Phone (317) 695-0153
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2991615 | Medicaid | OH |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 377484 | OH | MD | Registered Nurse |
| 400929290609 | OH | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342310400000",
"number": "1558616680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9470 HUNT RD",
"city": "ST LOUISVILLE",
"state": "OH",
"postal_code": "430719758",
"telephone_number": "317-695-0153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9470 HUNT RD",
"city": "ST LOUISVILLE",
"state": "OH",
"postal_code": "430719758",
"telephone_number": "317-695-0153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GITCHEL",
"first_name": "THOMAS",
"middle_name": "WALLACE",
"name_suffix": "Jr.",
"credential": "STNA, RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-15",
"last_updated": "2012-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "377484",
"primary": true
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": "400929290609",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2991615",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Louisville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.