Individual provider Active NPI

Kishon Gallmon

  • Family Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1114805710
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0013229 Issued in DE
Practice address
4512 Kirkwood Hwy Ste 300
Wilmington, DE 19808-5129
Phone
(302) 623-7500
Fax
(302) 623-7505
NPI assigned
Aug 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0013229 DE Primary
Registered Nurse 163W00000X L1-0047657 DE
Nurse Practitioner 363L00000X LG-0013229 DE

Addresses

Primary practice location

4512 Kirkwood Hwy Ste 300
Wilmington, DE 19808-5129

Mailing address

4512 Kirkwood Hwy Ste 300
Wilmington, DE 19808-5129
Phone (302) 623-7500

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
I20251015001289 DE Practitioner - Nurse Practitioner 2062909849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4512 Kirkwood Hwy
Suite 300
Wilmington, DE 19808-5129
Phone (302) 623-7500

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1-0047657DEMDRegistered Nurse
LG-0013229DEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Nurse Practitioner Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Oct 1, 2025 Accepting new patients
Christiana Care Health Services, Inc Nurse Practitioner CurrentSince Oct 1, 2025 Accepting new patients
Christiana Care Health Services, Inc Past Accepting new patients

Locations

726 Yorklyn Rd
Ste 100
Hockessin, DE 19707
Phone (302) 234-5770

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

4512 Kirkwood Hwy
Ste 300
Wilmington, DE 19808
Phone (302) 623-7500

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1114805710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 KIRKWOOD HWY STE 300",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085129",
            "telephone_number": "302-623-7500",
            "fax_number": "302-623-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 KIRKWOOD HWY STE 300",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085129",
            "telephone_number": "302-623-7500",
            "fax_number": "302-623-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLMON",
        "first_name": "KISHON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0013229",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0047657",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0013229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.