Patricia A Gilmore, RDA, AUXILIARY

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

7000 W Interstate 30 Apt 1023
Royse City, TX 75189-7562

Phone

(214) 694-1051

Fax

(972) 692-6918

NPI assigned

Nov 22, 2019

Last updated

Nov 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1114563343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 W INTERSTATE 30 APT 1023",
            "city": "ROYSE CITY",
            "state": "TX",
            "postal_code": "751897562",
            "telephone_number": "214-694-1051",
            "fax_number": "972-692-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 W INTERSTATE 30 APT 1023",
            "city": "ROYSE CITY",
            "state": "TX",
            "postal_code": "751897562",
            "telephone_number": "214-694-1051",
            "fax_number": "972-692-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "RDA, AUXILIARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "834262189",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "AAHC7782@GMAIL.COM",
            "affiliation": "N",
            "address_1": "7000 W Interstate 30 Apt 1023",
            "city": "Royse City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751897562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.