Individual provider Active NPI

Kiley R Gilbert, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1083007843
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
202004476NP-PP Issued in OR
Practice address
1802 W 4TH St
Wilmington, DE 19805-3420
Phone
(302) 655-5822
NPI assigned
Mar 17, 2015
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0992260 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7179 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202004476NP-PP OR Primary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 1631093 CO

Addresses

Primary practice location

1802 W 4TH St
Wilmington, DE 19805-3420

Mailing address

816 Larvik LN
Stoughton, WI 53589-5313
Phone (097) 216-3393

Other practice location 1

548 SW 13th St
Bend, OR 97702-3184
Phone (541) 388-8459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20200109002712 DE Practitioner - Nurse Practitioner 8022394675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westside Family Healthcare, Inc.Group PAC ID 6800706599, 58 clinicians

Practice addresses (Care Compare)

1802 W 4TH St
Wilmington, DE 19805-3420
Phone (302) 655-5576

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7179MNMDChiropractor
1631093COMDChild & Adolescent Psychiatric/Mental Health Registered Nurse
0992260COMDPsychiatric/Mental Health Nurse Practitioner
202004476NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Family Healthcare, Inc. CurrentSince Dec 13, 2019 Accepting new patients

Locations

1802 W 4th St
Wilmington, DE 19805
Phone (302) 655-5576

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1083007843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 LARVIK LN",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535895313",
            "telephone_number": "097-216-3393",
            "fax_number": "503-352-8658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 W 4TH ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198053420",
            "telephone_number": "302-655-5822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "548 SW 13th St",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977023184",
            "country_code": "US",
            "telephone_number": "541-388-8459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "KILEY",
        "middle_name": "R",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-17",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0992260",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "7179",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202004476NP-PP",
            "primary": true
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CO",
            "license": "1631093",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.