Blake Mitchell Gilbert

Primary specialty

PsychologistTaxonomy code 103T00000X

License

599 Issued in ND

Practice address

2611 Woodlawn Rd
Sterling, IL 61081-4151

Phone

(815) 625-0013

NPI assigned

Aug 14, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

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

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Human Service CenterGroup PAC ID 8527027556, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Southeast Behavioral Health Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fargo, ND
  • NPI 1932146941
  Medicare reassignment Care Compare group NPD
• Badlands Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dickinson, ND
  • NPI 1124072525
  Medicare reassignment NPD
• Lake Region Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Devils Lake, ND
  • NPI 1669411930
  Medicare reassignment NPD
• North Central Behavioral Health Clinic

  • Clinic/Center
  • Minot, ND
  • NPI 1477592533
  Medicare reassignment NPD
• Northeast Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Forks, ND
  • NPI 1366496341
  Medicare reassignment NPD
• Northwest Behavioral Health Clinic

  • Adult Mental Health Clinic/Center
  • Williston, ND
  • NPI 1770524613
  Medicare reassignment NPD
• South Central Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jamestown, ND
  • NPI 1225075906
  Medicare reassignment NPD
• West Central Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bismarck, ND
  • NPI 1649226713
  Medicare reassignment NPD
• Northeast Human Service Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Grand Forks, ND
  • NPI 1891808978
  NPD
• Badlands Behavioral Health Clinic

  • Community/Behavioral Health Agency
  • Dickinson, ND
  • NPI 1952828360
  NPD (past)

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1578996567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 9TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032350",
            "telephone_number": "701-298-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 WOODLAWN RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610814151",
            "telephone_number": "815-625-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "BLAKE",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "599",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer M Garriott, N.P.
• Eric E Gaumer, D.C.
• Genesis Healthcare, Inc
• Michael Gerberi, M.D.
• Rachel Marie Ghrist, BS, MHP
• Leah Gilmore
• Rajan Gopal, M.D.
• Suman Gopal, M.D.
• Angela M Gorzny, RN
• Grand Victorian of Sterling Master Lessee, LLC

• Psychologist in Sterling, IL
• Providers in Sterling, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.