Active NPI
Gerwyn Evans Heath, LPA
- Psychologist
- Ahoskie, NC
National Provider Identifier
1578692190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1197
- Practice address
- 226 Academy St S
Ahoskie, NC 27910-2451 - Phone
- (252) 332-2540
- Fax
- (252) 332-2540
- NPI assigned
- Mar 2, 2007
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1197 | NC | |
| Psychologist | 103T00000X | 1197 | NC | Primary |
Addresses
Primary practice location
226 Academy St S
Ahoskie, NC 27910-2451
Mailing address
226 Academy St S
Ahoskie, NC 27910-2451
Phone (252) 332-2540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6107378 | Medicaid | NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1197 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201219200000",
"number": "1578692190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "226 ACADEMY ST S",
"city": "AHOSKIE",
"state": "NC",
"postal_code": "279102451",
"telephone_number": "252-332-2540",
"fax_number": "252-332-2540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "226 ACADEMY ST S",
"city": "AHOSKIE",
"state": "NC",
"postal_code": "279102451",
"telephone_number": "252-332-2540",
"fax_number": "252-332-2540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATH",
"first_name": "GERWYN",
"middle_name": "EVANS",
"name_prefix": "Mr.",
"credential": "LPA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-02",
"last_updated": "2008-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "1197",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "1197",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6107378",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ahoskie, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.