Marc Elliott Gosnell, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

100689851 Issued in WI

Practice address

W3985 County Road NN
Elkhorn, WI 53121-4337

Phone

(262) 741-2121

Fax

(262) 741-2178

NPI assigned

Apr 11, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1043063654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 SW 27TH CT",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339145496",
            "telephone_number": "239-471-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3985 COUNTY ROAD NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214337",
            "telephone_number": "262-741-2121",
            "fax_number": "262-741-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSNELL",
        "first_name": "MARC",
        "middle_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "100689851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia L Gasparino, LPN
• Holly Michelle Gifford, LPC-IT
• Brittni L Gilling, APRN, FNP-BC
• Lorelei E Glas
• Robin Lee Gosh, LPN
• Nakash Grant, MD
• Ellen Green, CADC III, CCS
• Greendale Dental Associates, S.C.
• Sheri H Grev ER-Skomski, SAC
• Chad Michael Greving, D.D.S

• Student in an Organized Health Care Education/Training Program in Elkhorn, WI
• Providers in Elkhorn, WI by specialty
• Student in an Organized Health Care Education/Training Program in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.

Verify at the official NPI Registry.