CALLIE GUNN – Clinical Social Worker, NPI 1003483215

CALLIE GUNN is a healthcare provider. based in Port huron, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 6851109796 (MI). The NPI Number for CALLIE GUNN is 1003483215

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
CALLIE GUNN
NPI
1003483215
Phone
Not provided
Address
3111 ELECTRIC AVE
Enumeration Date
7 June 2021
Last Update Date
31 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8109858900
Graduation Year
2021 (5 years ago)
PAC ID
0042666554
Group Practice PAC ID
7416861984
Professional Enrollment ID
I20231019001322
Address ID
MI480608127PO3111XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:5State licenses:2Digital endpointsOther names

4,820 CLINICAL SOCIAL WORKER in MI

Provider Addresses for CALLIE GUNN

  • 3111 ELECTRIC AVE

    PORT HURON, MI 480608127

    Phone:

    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: 2023-10-19

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
I20231019001322IClinical Social WorkerMITBD

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 48060)

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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: 7416861984View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
-MI
-MI
Nurse PractitionerMI
Clinical Social WorkerMI
P S Y C H I A T R YMI
P S Y C H I A T R YMI
Mental Health CounselorMI

Reviews

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Frequently asked questions

How is CALLIE GUNN identified in CMS data?
CMS-hosted NPPES data lists CALLIE GUNN with NPI 1003483215.
Does the file indicate CALLIE GUNN is practicing under active NPI?
Directory data currently reports CALLIE GUNN as active.
What taxonomy line describes CALLIE GUNN?
For research purposes, treat CALLIE GUNN as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
Where is CALLIE GUNN based?
CALLIE GUNN is tied to Port Huron, Michigan in the data we show; additional addresses may exist on the full record.
Is the information about CALLIE GUNN up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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3111 ELECTRIC AVE
NPI: 1649288879