Katlyn Gorgus

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

42D Medical Group
300 S. Twining St., BLDG 760
Maxwell Afb, AL 36112-6027

Phone

(580) 481-7082

NPI assigned

Oct 13, 2022

Sex

Female

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

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": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1174249981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 2ND ST NE",
            "city": "ARAB",
            "state": "AL",
            "postal_code": "350165411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42D MEDICAL GROUP",
            "address_2": "300 S. TWINING ST., BLDG 760",
            "city": "MAXWELL AFB",
            "state": "AL",
            "postal_code": "361126027",
            "telephone_number": "580-481-7082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORGUS",
        "first_name": "KATLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John N Gayk, MD
• Zachary Gerdes, PHD
• Holly Bernadine Gerstner-Norris, MS, LAT, ATC, PES
• Paula Sue Giamo, PA-C
• Andrew Gieger, MD
• Courtney Michelle Hall
• Thomas Wade Hardison III, DMD
• Michelle Harting
• Emily Hodges
• Weilun Hsu

• Independent Duty Medical Technicians in Maxwell Afb, AL
• Providers in Maxwell Afb, AL by specialty
• Independent Duty Medical Technicians in Alabama

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