Kristi Gannon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904010874 Issued in VA

Practice address

2425 E Commercial Blvd Ste 405
Fort Lauderdale, FL 33308-4029

Phone

(855) 284-7483

NPI assigned

Feb 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, FL2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  DC

  Medicare reassignment Care Compare group NPD
• Thriveworks Clinical - Florida Inc

  • Mental Health Counselor
  • Fort Lauderdale, FL
  • NPI 1396360996
  Medicare reassignment NPD

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1952867111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JEFFERSON ST STE 2C",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245041724",
            "telephone_number": "703-828-9054",
            "fax_number": "617-807-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 E COMMERCIAL BLVD STE 405",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084029",
            "telephone_number": "855-284-7483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6076 Franconia Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223101768",
            "country_code": "US",
            "telephone_number": "703-828-9054",
            "fax_number": "617-807-0958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15784 NW 12th Ct",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281614",
            "country_code": "US",
            "telephone_number": "855-284-7483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANNON",
        "first_name": "KRISTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paris Gandy-Walker, PSYD
• Keira Nakita Gandy, MS, OTR/L
• Juma Gangadeen, FNP-C
• Jamie L Ganger, LCSW
• Tricia A Gangoo, PHARMD
• Marc Jay Gannon, O.D.
• Theodore William Gannon, L. AC.
• Anasuya Gaonkar, MD
• Roya Garakani
• Kelly Ann Garasz, RN

• Clinical Social Worker in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.