Individual provider Active NPI

Jerry Gillette, MSW

  • Clinical Social Worker
  • Battle Creek, MI
National Provider Identifier
1831224682
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801034739 Issued in MI
Practice address
391 S Shore Dr Ste 214
Battle Creek, MI 49014-5446
Phone
(269) 964-0153
Fax
(855) 877-5812
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 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 6801034739 MI Primary

Addresses

Primary practice location

391 S Shore Dr Ste 214
Battle Creek, MI 49014-5446

Mailing address

140 Michigan Ave W
Battle Creek, MI 49017-3602
Phone (269) 966-1460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040927000434 MI Practitioner - Clinical Social Worker 7315916434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
May accept Medicare assignment
Group practices
Comforts of Home Counseling and Care Management LLCGroup PAC ID 8123305802, 11 clinicians

Practice addresses (Care Compare)

391 S Shore Dr
Suite 214
Battle Creek, MI 49014-5446
Phone (269) 964-0153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801034739MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comforts of Home Counseling & Care Management LLC Clinical CurrentSince Sep 28, 2021 Accepting new patients
Summit Pointe Clinical CurrentSince Apr 7, 1997 Accepting new patients

Locations

8472 Reliable Pkwy
Chicago, IL 60686

105 S Superior St
Albion, MI 49224
Phone (517) 629-2191

391 S Shore Dr
Ste 214
Battle Creek, MI 49014
Phone (269) 245-5440

140 Michigan Ave W
Battle Creek, MI 49017
Phone (269) 966-1460

215 Roosevelt Ave E
Battle Creek, MI 49037
Phone (269) 969-6126

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1831224682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MICHIGAN AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173602",
            "telephone_number": "269-966-1460",
            "fax_number": "269-966-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 S SHORE DR STE 214",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490145446",
            "telephone_number": "269-964-0153",
            "fax_number": "855-877-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "JERRY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801034739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.