Individual provider Active NPI

Gabrielle Nicole Kendzerski

  • Family Nurse Practitioner
  • Sylva, NC
National Provider Identifier
1174243232
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5016927 Issued in NC
Practice address
176 Walmart PLZ
Sylva, NC 28779-5808
Phone
(828) 631-9462
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5016927 NC Primary

Addresses

Primary practice location

176 Walmart PLZ
Sylva, NC 28779-5808

Mailing address

176 Walmart PLZ
Sylva, NC 28779-5808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20221108001825 NC Practitioner - Nurse Practitioner 8921475716 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Harris Regional Hospital LLC CurrentSince Dec 1, 2022 Accepting new patients
DLP Western Carolina Physician Practices LLC CurrentSince Dec 1, 2024 Accepting new patients
DLP Western Carolina Physician Practices LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

98 Doctors Dr
Ste 200
Sylva, NC 28779
Phone (828) 586-8971

176 Walmart Plz
Sylva, NC 28779
Phone (828) 631-8282

68 Hospital Rd
Sylva, NC 28779
Phone (828) 586-7351

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1174243232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 WALMART PLZ",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287795808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 WALMART PLZ",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287795808",
            "telephone_number": "828-631-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDZERSKI",
        "first_name": "GABRIELLE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylva, NC

Sources for this page

Verify at the official NPI Registry.