Marc Gerdes
Individual provider Active NPI Community Health Worker · Greenville, CA
NPI 1720360985 · NPPES record last updated Sep 14, 2011
Key facts
- NPI
- 1720360985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- License
- 1253993610035 (NV)
- Practice address
- 312 Crescent St
Greenville, CA 95947 - Phone
- (530) 284-7007
- NPI assigned
- Sep 14, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1253993610035 | NV | MD | Community Health Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain Circle Family Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 1253993610035 | NV | Yes |
Addresses
Primary practice location
312 Crescent St
Greenville, CA 95947
Mailing address
PO Box 554
Greenville, CA 95947-0554
Phone (530) 284-7007
Other providers in Greenville, CA
- Eastern Plumas Health Care District
- Joshua Francis Etchegoyhen
- Judy Evans
- Angela Freeman
- Darrin Freeman
- Sue Gerdes
- Christine M. Gibson
- Kevin Barrie Goss
- Dawn Marie Granata
- Greenville Rancheria
All providers in Greenville, CA · Community Health Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.