Kelly P Gambino, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

TP002302Q Issued in PA

Practice address

999 Lake Hunter Cir Ste D
Mount Pleasant, SC 29464-5427

Phone

(843) 375-0270

NPI assigned

Jun 2, 2008

Last updated

Feb 24, 2022By the provider in NPPES

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

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1215196670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 LAKE HUNTER CIR STE D",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294645427",
            "telephone_number": "843-375-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 LAKE HUNTER CIR STE D",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294645427",
            "telephone_number": "843-375-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBINO",
        "first_name": "KELLY",
        "middle_name": "P",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "TP002302Q",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karyla Gaines, M.ED., LPC
• Daniel Rossario Gaita, MA, LISW-CP
• Ryan Joseph Galica, M.D.
• Frank Louis Galizia, OD
• Lacy Ann Gallagher, PHARMD
• Ashley Gamble
• Taylor Elizabeth Gannon, OTR
• John Robert Ganz, M.D.
• Kimberly Ganz
• Jeffrey Jerome Gardner, D.M.D., P.A.

• Nurse Practitioner in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.