Active NPI
Michael Gene Gipson, LCSW
- Clinical Social Worker
- Jonesboro, AR
National Provider Identifier
1821024704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 4508 Stadium Blvd
Jonesboro, AR 72404-9675 - Phone
- (870) 933-6886
- Fax
- (870) 933-9395
- NPI assigned
- Jun 23, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
4508 Stadium Blvd
Jonesboro, AR 72404-9675
Mailing address
4508 Stadium Blvd
Jonesboro, AR 72404-9675
Phone (870) 933-6886
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5W419 | Other | AR | BLUE CROSS NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4546 N Federal Hwy
Fort Lauderdale, FL 33308-5204
Phone (954) 716-6514
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theracounsel, Inc. | Clinical | Current | Accepting new patients |
Locations
4546 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 328-6163
2040 N Dixie Hwy
Ste 229
Wilton Manors, FL 33305
Phone (954) 478-0770
Networks
- Freedom Health HMO Network
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.
-
- Clinical Social Worker
- Ft Lauderdale, FL
- NPI 1457460339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821024704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4508 STADIUM BLVD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724049675",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4508 STADIUM BLVD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724049675",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIPSON",
"first_name": "MICHAEL",
"middle_name": "GENE",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS NUMBER",
"identifier": "5W419",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jonesboro, AR
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.