DR. JAY RANDALL GOTTSCHALK PHD APRN PMHNP-BC NPI 1437660248

NPI Information

NPI: 1437660248
Provider Name: DR. JAY RANDALL GOTTSCHALK, PHD, APRN, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
804 SERVICE RD STE A110
EAST LANSING, MI
ZIP 48824
Phone: (517) 353-8122
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DR. Jay Randall Gottschalk, PHD, APRN, PMHNP-BC is a psychiatric/mental health nurse practitioner in East Lansing, MI with 7 years of experience. DR. Jay Randall Gottschalk, PHD, APRN, PMHNP-BC NPI is 1437660248. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

804 SERVICE RD STE A110
EAST LANSING, MI
ZIP 48824-015
Phone: (517) 353-8122
Fax: (517) 432-3713

The NPI 1437660248 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/19/2017 and was last updated on 2/27/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	364SP0808X	Clinical Nurse Specialist	Psychiatric/Mental Health	4704296264	MICHIGAN	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	4704296264	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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