Breosha Gilbert-Shogelola

Primary specialty

Social WorkerTaxonomy code 104100000X

License

33010805A Issued in IN

Practice address

515 W Camp St
Lebanon, IN 46052-1648

Phone

(765) 482-5900

NPI assigned

Nov 28, 2023

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 IN

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 Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Osh-in Physicians Group PCGroup PAC ID 6800100512, 62 clinicians

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.

• Osh-in Physicians Group, PC

  • Primary Care Clinic/Center
  • Indianapolis, IN
  • NPI 1073995338
  Medicare reassignment Care Compare group NPD
• Indiana United Methodist Children's Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Lebanon, IN
  • NPI 1275812653
  NPD (past)
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643
  NPD (past)

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1972379204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W CAMP ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521648",
            "telephone_number": "765-482-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W CAMP ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521648",
            "telephone_number": "765-482-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT-SHOGELOLA",
        "first_name": "BREOSHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33010805A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle C Geiss, PA
• Donald Joseph Gentile, MD
• Gentle Family Dentistry PC
• Ronda George, NP-C
• Hagop Ghareebian, MD
• Bhupinder K Gill, PT
• Abigail Gliva
• God and Son We Trust, LLC
• Zoe Goebel, RBT
• Gabrielle E. Goldstein, LCSW

• Social Worker in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.