Ronald John Gammon, CADCIII CCS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2136 Issued in WI

Practice address

North Shore Center
10303 N Port Washington Rd SQ 203
Meguon, WI 53092

Phone

(262) 241-5955

Fax

(262) 241-5926

NPI assigned

Dec 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• North Shore Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mequon, WI
  • NPI 1780755389
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760540405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTH SHORE CENTER",
            "address_2": "10303 N PORT WASHINGTON RD SQ 203",
            "city": "MEGUON",
            "state": "WI",
            "postal_code": "53092",
            "telephone_number": "262-241-5955",
            "fax_number": "262-241-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTH SHORE CENTER",
            "address_2": "10303 N PORT WASHINGTON RD SQ 203",
            "city": "MEGUON",
            "state": "WI",
            "postal_code": "53092",
            "telephone_number": "262-241-5955",
            "fax_number": "262-241-5926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMON",
        "first_name": "RONALD",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "CADCIII CCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "2136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John W Miller, DDS

• Addiction (Substance Use Disorder) Counselor in Meguon, WI
• Providers in Meguon, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.