Individual provider Active NPI

Mark Thomas McGonigle, LCSW

  • Clinical Social Worker
  • Kansas City, MO
National Provider Identifier
1689616559
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2003019074 Issued in MO
Practice address
217 E 63Rd St
Kansas City, MO 64113-2224
Phone
(816) 822-0200
Fax
(816) 444-6425
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2003019074 MO Primary

Addresses

Primary practice location

217 E 63Rd St
Kansas City, MO 64113-2224

Mailing address

222 W Gregory Blvd
Ste 310
Kansas City, MO 64114-1127
Phone (816) 822-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040809000939 MO Practitioner - Clinical Social Worker 4688646888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

222 W Gregory Blvd
Suite 310
Kansas City, MO 64114-1127
Phone (816) 822-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Mind Therapy Services, LLC CurrentSince Apr 1, 2008 Accepting new patients

Locations

222 W Gregory Blvd
Ste 310
Kansas City, MO 64114
Phone (816) 822-0200

217 E 63rd St
Kansas City, MO 64113
Phone (816) 444-5710

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1689616559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W GREGORY BLVD",
            "address_2": "STE 310",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141127",
            "telephone_number": "816-822-0200",
            "fax_number": "816-895-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E 63RD ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641132224",
            "telephone_number": "816-822-0200",
            "fax_number": "816-444-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGONIGLE",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2003019074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.