GARY OWEN ANDERSON – Clinical Social Worker, NPI 1467089656

GARY OWEN ANDERSON is a healthcare provider. based in Clinton, Indiana. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 34008561A (IN). The NPI Number for GARY OWEN ANDERSON is 1467089656

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
GARY OWEN ANDERSON
NPI
1467089656
Phone
(765) 828-1003
Address
777 S MAIN ST STE 100
Enumeration Date
26 March 2020
Last Update Date
27 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7658281003
Graduation Year
1987 (39 years ago)
PAC ID
2264830819
Group Practice PAC ID
7618067265
Professional Enrollment ID
I20211012001315
Address ID
IN478422493CL777XXSTXX401

Contacts

Secure Messaging
ganderson@vpchc.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness85
Years active:6State licenses:1Other namesUpdated within 12 months

1,711 CLINICAL SOCIAL WORKER in IN

Provider Addresses for GARY OWEN ANDERSON

  • 777 S MAIN ST STE 100

    CLINTON, IN 478422493

    Phone: (765) 828-1003

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-10-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20211012001315IClinical Social WorkerINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 47842)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7618067265View full group profile
NameSpecialtyState
-IN
Clinical Social WorkerIN
Nurse PractitionerIN
Family PracticeIN
-IN
Clinical Social WorkerIN
-IN
Clinical Social WorkerIN
Clinical PsychologistIN
Nurse PractitionerIN

Reviews

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Frequently asked questions

What unique ID ties claims to GARY OWEN ANDERSON?
NPI 1467089656 is assigned to GARY OWEN ANDERSON under the national enumeration system.
Is GARY OWEN ANDERSON active in the national directory?
GARY OWEN ANDERSON's public NPI profile is in an active state.
Can you summarize GARY OWEN ANDERSON's specialty in plain language?
Clinically, the directory lists GARY OWEN ANDERSON with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does GARY OWEN ANDERSON practice in Indiana?
You will see Clinton, Indiana on file for GARY OWEN ANDERSON alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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