Active NPI
Gloria J Meares, PHD
- Clinical Psychologist
- Raleigh, NC
National Provider Identifier
1992735401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1173
- Practice address
- 4020 Westchase Blvd
Ste 130
Raleigh, NC 27607-3938 - Phone
- (919) 828-7244
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
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 Psychologist | 103TC0700X | 1173 | NC | Primary |
Addresses
Primary practice location
4020 Westchase Blvd
Ste 130
Raleigh, NC 27607-3938
Mailing address
4020 Westchase Blvd
Ste 130
Raleigh, NC 27607-3938
Phone (919) 828-7244
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7124763 | Other | NC | MAMSI |
| A3001833 | Other | VALUE BEL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Sep 20, 2015 through Sep 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1173 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992735401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4020 WESTCHASE BLVD",
"address_2": "STE 130",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276073938",
"telephone_number": "919-828-7244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 WESTCHASE BLVD",
"address_2": "STE 130",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276073938",
"telephone_number": "919-828-7244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEARES",
"first_name": "GLORIA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "1173",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "7124763",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE BEL",
"identifier": "A3001833",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.