Jackie Gilbertson, LICENSED PSYCHOLOGIS

Primary specialty

PsychologistTaxonomy code 103T00000X

License

276 SD Issued in SD

Practice address

623 Quincy St
Suite 102
Rapid City, SD 57701-8231

Phone

(605) 430-6364

Fax

(605) 716-9491

NPI assigned

Jan 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

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

Specialty

Clinical Psychologist

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr.Jackiegilbertsonllc

  • Community/Behavioral Health Agency
  • Rapid City, SD
  • NPI 1124383435
  Medicare reassignment NPD Authorized official
• Deer Oaks Black Hills

  • Clinical Psychologist
  • Sioux Falls, SD
  • NPI 1932364726
  NPD (past)

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1952380289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623QUINCY",
            "address_2": "SUITE 102",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013619",
            "telephone_number": "605-430-6364",
            "fax_number": "605-716-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 QUINCY ST",
            "address_2": "SUITE 102",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577018231",
            "telephone_number": "605-430-6364",
            "fax_number": "605-716-9491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERTSON",
        "first_name": "JACKIE",
        "name_prefix": "Dr.",
        "credential": "LICENSED PSYCHOLOGIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SD",
            "license": "276 SD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6551113",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Gilbert
• Donna Marie Gilbert
• James A Gilbert, MD
• Katherine Denise Gilbert, APRN, FNP-C
• Molly Ann Gilbert, MD
• Sarah J Giles, MT
• Nathan Gilford, CSW
• Timothy J Gill, MD
• Katie Gillaspie
• Alexia Georgas Gillen, DO

• Psychologist in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Psychologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.

Verify at the official NPI Registry.