Active NPI
James Gadd
- Counselor
- Shelby TWP, MI
National Provider Identifier
1720570369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401011692
- Practice address
- 50258 Van Dyke Ave
Shelby TWP, MI 48317-1374 - Phone
- (586) 884-4714
- NPI assigned
- May 30, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401011692 | MI | Primary |
Addresses
Primary practice location
50258 Van Dyke Ave
Shelby TWP, MI 48317-1374
Mailing address
50258 Van Dyke Ave
Shelby TWP, MI 48317-1374
Phone (586) 884-4714
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 813601247 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401011692 | MI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1720570369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50258 VAN DYKE AVE",
"city": "SHELBY TWP",
"state": "MI",
"postal_code": "483171374",
"telephone_number": "586-884-4714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50258 VAN DYKE AVE",
"city": "SHELBY TWP",
"state": "MI",
"postal_code": "483171374",
"telephone_number": "586-884-4714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GADD",
"first_name": "JAMES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-30",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401011692",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "813601247",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelby TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.