Individual provider Active NPI

Nina Gabrielle Gonzalez

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1750717252
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21433 Issued in MD
Practice address
1012 North Point Rd
Baltimore, MD 21224-3338
Phone
(443) 216-4800
Fax
(443) 216-4801
NPI assigned
Sep 17, 2013
Last updated
May 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 21433 MD Primary

Addresses

Primary practice location

1012 North Point Rd
Baltimore, MD 21224-3338

Mailing address

1204 Walker Ave
Baltimore, MD 21239-1740
Phone (443) 564-6772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: No
  • 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
I20240610000026 MD Practitioner - Clinical Social Worker 7810439643 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21433MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Key Point Health Services, Inc. CurrentSince May 28, 2024 Accepting new patients
Key Point Health Services, Inc CurrentSince May 28, 2024 Accepting new patients

Locations

135 N Parke St
Aberdeen, MD 21001
Phone (443) 625-1600

1012 S North Point Rd
Baltimore, MD 21224
Phone (410) 285-2110

500 N Rolling Rd
Catonsville, MD 21228
Phone (410) 788-0300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1750717252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 WALKER AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212391740",
            "telephone_number": "443-564-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 NORTH POINT RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243338",
            "telephone_number": "443-216-4800",
            "fax_number": "443-216-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "NINA",
        "middle_name": "GABRIELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "21433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.