Provider Demographics
NPI:1508852823
Name:MCAREAVEY, GIDGET L (OTR)
Entity Type:Individual
Prefix:
First Name:GIDGET
Middle Name:L
Last Name:MCAREAVEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:GIDGET
Other - Middle Name:L
Other - Last Name:BUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1720 S CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2129
Mailing Address - Country:US
Mailing Address - Phone:605-334-5630
Mailing Address - Fax:605-332-5327
Practice Address - Street 1:1720 S CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2129
Practice Address - Country:US
Practice Address - Phone:605-334-5630
Practice Address - Fax:605-332-5327
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102491225X00000X
SD0505225X00000X
IA01509225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD33486OtherSIOUX VALLEY HEALTH PLANS
SD5833760Medicaid
SD64-03804OtherMEDICA
SD1782309OtherARAZ
SD4997012OtherBLUE CROSS BLUE SHIELD SD
SD64-03805OtherMEDICA
SD64-04052OtherMEDICA
SD308T9MCOtherBLUE CROSS BLUE SHIELD MN
SD4994828OtherBLUE CROSS BLUE SHIELD SD
SD5833762Medicaid
SD5833763Medicaid
SD64-05332OtherMEDICA
SD4996127OtherBLUE CROSS BLUE SHIELD SD
SD4996439OtherBLUE CROSS BLUE SHIELD SD
SD5833765Medicaid