Individual provider Active NPI

Gerri M. McGinnis, PHD

  • Clinical Neuropsychologist
  • Philadelphia, PA
National Provider Identifier
1972523033
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS-007064-L Issued in PA
Practice address
909 Walnut St
2ND Floor
Philadelphia, PA 19107-5211
Phone
(215) 955-7000
Fax
(215) 503-7007
NPI assigned
Jul 20, 2006
Last updated
Oct 30, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS-007064-L PA Primary

Addresses

Primary practice location

909 Walnut St
2ND Floor
Philadelphia, PA 19107-5211

Mailing address

615 Chestnut St
14TH Floor, Central Enrollment
Philadelphia, PA 19106-4404
Phone (215) 955-1175

Other identifiers 1

IdentifierTypeStateIssuer
8841004MedicaidNJ

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS-007064-LPAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1972523033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CHESTNUT ST",
            "address_2": "14TH FLOOR, CENTRAL ENROLLMENT",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064404",
            "telephone_number": "215-955-1175",
            "fax_number": "215-955-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 WALNUT ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075211",
            "telephone_number": "215-955-7000",
            "fax_number": "215-503-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGINNIS",
        "first_name": "GERRI",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS-007064-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8841004",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.