Individual provider Active NPI

Makeda Gant

  • Family Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1003201039
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
116446 Issued in OK
Practice address
1 Embarcadero Ctr FL 19
San Francisco, CA 94111-3628
Phone
(415) 658-6791
Fax
(415) 252-7176
NPI assigned
Apr 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0991567-NP CO
Family Nurse Practitioner 363LF0000X 116446 OK Primary
Family Nurse Practitioner 363LF0000X 1194341 TX
Family Nurse Practitioner 363LF0000X AP61645279 WA
Family Nurse Practitioner 363LF0000X 316037 AZ
Family Nurse Practitioner 363LF0000X 5021596 NC

Addresses

Primary practice location

1 Embarcadero Ctr FL 19
San Francisco, CA 94111-3628

Mailing address

1 Embarcadero Ctr FL 19
San Francisco, CA 94111-3628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200331001212 CO Practitioner - Nurse Practitioner 3072832740 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
316037AZMDFamily Nurse Practitioner
5021596NCMDFamily Nurse Practitioner
116446OKMDFamily Nurse Practitioner
1194341TXMDFamily Nurse Practitioner
AP61645279WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Apr 13, 2020 Accepting new patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Apr 13, 2020 Accepting new patients
Melton Health and Medical Services Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 6300
Broomfield, CO 80021
Phone (303) 272-0803

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1003201039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR FL 19",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113628",
            "fax_number": "415-252-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR FL 19",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113628",
            "telephone_number": "415-658-6791",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANT",
        "first_name": "MAKEDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0991567-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "116446",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1194341",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61645279",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "316037",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.