Individual provider Active NPI

Gabrielle B Gunsam

  • Registered Nurse
  • Smithtown, NY
National Provider Identifier
1205375292
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
797792 Issued in NY
Practice address
14 Bellemeade Ave
Smithtown, NY 11787-1857
Phone
(631) 265-5300
NPI assigned
Feb 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 325665 NY
Registered Nurse 163W00000X 797792 NY Primary

Addresses

Primary practice location

14 Bellemeade Ave
Smithtown, NY 11787-1857

Mailing address

1110 Udall Rd
Bay Shore, NY 11706-2718
Phone (646) 684-6069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
797792NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Nursing Registry, Inc. Past Accepting new patients
Christian Nursing Registry Inc. Past Accepting new patients

Organizations & group practices 2

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": "1487808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1205375292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 UDALL RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117062718",
            "telephone_number": "646-684-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 BELLEMEADE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871857",
            "telephone_number": "631-265-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNSAM",
        "first_name": "GABRIELLE",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-23",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "325665",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "797792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.