ZACHARY GERDES, PhD — NPI 1639734056 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1639734056

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103T00000X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist

Box 32 Service Location & ZIP+4

300 S TWINING ST, BLDG 760, MAXWELL AIR FORCE BASE 42D MEDICAL GROUP, MAXWELL AFB, AL, 36112-6219

✓ 9-Digit EDI 837 ZIP+4 (36112-6219)

Practice Phone & Referral Fax

(334) 953-5430

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1639734056 (ZACHARY GERDES, PhD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1639734056` (NPI-1 Individual Practitioner)
Provider / Legal Name	ZACHARY GERDES, PhD
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist NUCC Code: `103T00000X` (Psychologist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	300 S TWINING ST, BLDG 760, MAXWELL AIR FORCE BASE 42D MEDICAL GROUP, MAXWELL AFB, AL, 36112-6219
Practice Telephone / Fax	Tel: (334) 953-5430
Administrative Mailing Address	3136 FITZGERALD RD, MONTGOMERY, AL, 36106-2633
Enumeration & Last Sync	Enumerated: 2019-05-01 \| CMS Record Updated: 2020-09-15

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

300 S TWINING ST, BLDG 760, MAXWELL AIR FORCE BASE 42D MEDICAL GROUP, MAXWELL AFB, AL, 36112-6219

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Plain-English Taxonomy & CMS Crosswalk (103T00000X)

What Does Taxonomy Code 103T00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103T00000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Psychologist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ZACHARY GERDES, PhD)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ZACHARY GERDES, PhD (NPI #1639734056)