Active NPI
Kerry Norman Gott, M.D.
- Infectious Disease Physician
- Pomona, CA
National Provider Identifier
1013955186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- G65566
- Practice address
- 255 E Bonita Ave
Pomona, CA 91767-1923 - Phone
- (909) 596-7733
- Fax
- (909) 450-0357
- NPI assigned
- Jun 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | G65566 | CA | Primary |
Addresses
Primary practice location
255 E Bonita Ave
Pomona, CA 91767-1923
Mailing address
PO Box 9389
Alta Loma, CA 91701-8389
Phone (909) 268-5645
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BK903Z | Other | MEDICARE NO CAL PTAN | |
| G65566 | Other | CA | CA LICENSE # |
| 00C655660 | Medicaid | CA | |
| GR0059670 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65566 | CA | MD | Pharmacist |
| G65566 | CA | MD | Infectious Disease Physician |
Organizations & group practices 1
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.
-
- Infectious Disease Physician
- Pomona, CA
- NPI 1417995598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1013955186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9389",
"city": "ALTA LOMA",
"state": "CA",
"postal_code": "917018389",
"telephone_number": "909-268-5645",
"fax_number": "909-450-0357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 E BONITA AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917671923",
"telephone_number": "909-596-7733",
"fax_number": "909-450-0357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTT",
"first_name": "KERRY",
"middle_name": "NORMAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2023-03-07",
"certification_date": "2020-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "CA",
"license": "G65566",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NO CAL PTAN",
"identifier": "BK903Z",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA LICENSE #",
"identifier": "G65566",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C655660",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0059670",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.