Active NPI
Gina Eileen Nelson
- Clinical Social Worker
- Folsom, CA
National Provider Identifier
1992217277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 555 Oakdale St Ste D
Folsom, CA 95630-2451 - Phone
- (916) 496-7663
- NPI assigned
- Oct 26, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
555 Oakdale St Ste D
Folsom, CA 95630-2451
Mailing address
555 Oakdale St Ste D
Folsom, CA 95630-2451
Phone (916) 496-7663
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
172 S Academy Ave
Suite 150
Eagle, ID 83616-6564
Phone (916) 496-7663
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19822 | CA | MD | Certified Respiratory Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Authentic Gains LLC | Clinical | Current | Accepting new patients |
Locations
555 Oakdale St
Ste D
Folsom, CA 95630
Phone (916) 496-7663
172 S Academy Ave
Ste 150
Eagle, ID 83616
Phone (208) 668-2701
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508976000000",
"number": "1992217277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 OAKDALE ST STE D",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956302451",
"telephone_number": "916-496-7663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 OAKDALE ST STE D",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956302451",
"telephone_number": "916-496-7663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "GINA",
"middle_name": "EILEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-26",
"last_updated": "2017-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Folsom, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.