Individual provider Active NPI

Bartley D Gibson, MSW LICSW

  • Clinical Social Worker
  • Buckhannon, WV
National Provider Identifier
1699074682
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
DP00941536 Issued in WV
Practice address
75 Poplar St
Buckhannon, WV 26201-7058
Phone
(304) 281-8920
NPI assigned
Mar 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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 DP00941536 WV Primary

Addresses

Primary practice location

75 Poplar St
Buckhannon, WV 26201-7058

Mailing address

180 Center St
Cramerton, NC 28032-1407
Phone (304) 281-8920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20240112000655 WV Practitioner - Clinical Social Worker 1355792557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2413 E Pike St
Suite 101
Clarksburg, WV 26301-0003
Phone (304) 281-8920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP00941536WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teach Them to Fish Inc Clinical CurrentSince Apr 1, 2024 Accepting new patients

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": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1699074682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 CENTER ST",
            "city": "CRAMERTON",
            "state": "NC",
            "postal_code": "280321407",
            "telephone_number": "304-281-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 POPLAR ST",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262017058",
            "telephone_number": "304-281-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "BARTLEY",
        "middle_name": "D",
        "credential": "MSW LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-16",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00941536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckhannon, WV

Sources for this page

Verify at the official NPI Registry.