Individual provider Active NPI

Gregory John Purchase, LCSW

  • Clinical Social Worker
  • Erie, PA
National Provider Identifier
1669986956
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW019898 Issued in PA
Practice address
2221 Peninsula Dr Ste 105
Erie, PA 16506-2954
Phone
(814) 969-3031
NPI assigned
Nov 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW133012 PA
Clinical Social Worker 1041C0700X CW019898 PA Primary

Addresses

Primary practice location

2221 Peninsula Dr Ste 105
Erie, PA 16506-2954

Mailing address

614 Lincoln Ave
Erie, PA 16505-5014
Phone (814) 969-3031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180604002415 PA Practitioner - Clinical Social Worker 3870858343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2221 Peninsula Dr
Erie, PA 16506-2954
Phone (814) 969-3031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW133012PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greg Purchase LLC CurrentSince Mar 30, 2018 Accepting new patients

Locations

2221 Peninsula Dr
Ste 105
Erie, PA 16506
Phone (814) 969-3031

2221 Peninsula Dr
Erie, PA 16506
Phone (814) 554-0622

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1669986956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 LINCOLN AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165055014",
            "telephone_number": "814-969-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 PENINSULA DR STE 105",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062954",
            "telephone_number": "814-969-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCHASE",
        "first_name": "GREGORY",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-22",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW133012",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.