Individual provider Active NPI

Anessa R Gilbride, LISW

  • Clinical Social Worker
  • Dayton, OH
National Provider Identifier
1821246919
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0700257 Issued in OH
Practice address
601 S Edwin C Moses Blvd
NW Building 4TH Floor
Dayton, OH 45408-1424
Phone
(937) 276-8333
Fax
(937) 276-8269
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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 I0700257 OH Primary

Addresses

Primary practice location

601 S Edwin C Moses Blvd
NW Building 4TH Floor
Dayton, OH 45408-1424

Mailing address

601 S Edwin C Moses Blvd
NW Building 4TH Floor
Dayton, OH 45408-1424
Phone (937) 276-8333

Other identifiers 1

IdentifierTypeStateIssuer
I0700257OtherOHSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • 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
I20080917000131 OH Practitioner - Clinical Social Worker 7719054717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Behavioral Health, Inc.Group PAC ID 0244148625, 7 clinicians

Practice addresses (Care Compare)

601 S Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone (937) 734-8333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0700257OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Behavioral Health, Inc. CurrentSince Aug 1, 2008 Accepting new patients
Samaritan Behavioral Health, Inc. Current Accepting new patients
Samaritan Behavioral Health, Inc. CurrentSince Aug 1, 2008 Accepting new patients

Locations

601 S Edwin C Moses Blvd
Fl 4
Dayton, OH 45417
Phone (937) 734-8333

601 S Edwin C Moses Blvd
Bldg 4TH
Dayton, OH 45417
Phone (937) 276-8333

601 S Edwin C Moses Blvd
Dayton, OH 45417
Phone (937) 734-4310

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/sbhihelp/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1821246919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "address_2": "NW BUILDING 4TH FLOOR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454081424",
            "telephone_number": "937-276-8333",
            "fax_number": "937-276-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "address_2": "NW BUILDING 4TH FLOOR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454081424",
            "telephone_number": "937-276-8333",
            "fax_number": "937-276-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBRIDE",
        "first_name": "ANESSA",
        "middle_name": "R",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0700257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "I0700257",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.