Individual provider Active NPI

Gerald Gillig, MSW

  • Clinical Social Worker
  • Saint Joseph, MO
National Provider Identifier
1972720571
Registry record updated May 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000344 Issued in MO
Practice address
724 N 22ND St
Saint Joseph, MO 64506-2604
Phone
(816) 236-2457
Fax
(816) 364-4211
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 000344 MO Primary

Addresses

Primary practice location

724 N 22ND St
Saint Joseph, MO 64506-2604

Mailing address

4919 Briarwood LN
Saint Joseph, MO 64506-3316
Phone (816) 279-5283

Other identifiers 1

IdentifierTypeStateIssuer
493224307MedicaidMO

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

State licenses

LicenseStateTypeSpecialty
000344MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1972720571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 BRIARWOOD LN",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063316",
            "telephone_number": "816-279-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 N 22ND ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062604",
            "telephone_number": "816-236-2457",
            "fax_number": "816-364-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIG",
        "first_name": "GERALD",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "000344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493224307",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; 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.