Rose Marie Gustilo, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

D23777 Issued in MD

Practice address

2518 Darda St
Henderson, NV 89044-1588

Phone

(702) 617-3597

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1023199429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 DARDA ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890441588",
            "telephone_number": "702-617-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 DARDA ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890441588",
            "telephone_number": "702-617-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTILO",
        "first_name": "ROSE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD035835E",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101050885",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D23777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136841",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khyati Gupta, D.O.
• Pervin N/a Gupta
• Sean S. Gupton, MD
• Mercedes Apolina Gurrola
• Gustavo Hernandez DMD PLLC
• Gutierrez MD, PLLC
• Krystal Gutierrez-Avila, LCSW
• Alexandra Gutierrez
• Arabella Gutierrez
• Astley Gutierrez

• Psychiatry Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Psychiatry Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.