Active NPI
Jill M Gamez, SAC
- Addiction (Substance Use Disorder) Counselor
- Menomonie, WI
National Provider Identifier
1871738633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 15396-131
- Practice address
- 320 21St St N
Menomonie, WI 54751-2228 - Phone
- (715) 235-4537
- NPI assigned
- Dec 9, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15396-131 | WI | Primary |
Addresses
Primary practice location
320 21St St N
Menomonie, WI 54751-2228
Mailing address
N6789 410TH St
Menomonie, WI 54751-4945
Phone (715) 235-9346
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15396-131 | WI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228780800000",
"number": "1871738633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N6789 410TH ST",
"city": "MENOMONIE",
"state": "WI",
"postal_code": "547514945",
"telephone_number": "715-235-9346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 21ST ST N",
"city": "MENOMONIE",
"state": "WI",
"postal_code": "547512228",
"telephone_number": "715-235-4537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMEZ",
"first_name": "JILL",
"middle_name": "M",
"credential": "SAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-09",
"last_updated": "2008-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "15396-131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menomonie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.