Individual provider Active NPI

Avery Gatewood

  • Electroneurodiagnostic Specialist/Technologist
  • San Antonio, TX
National Provider Identifier
1225425689
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
Practice address
1141 N Loop 1604 E # 105-446
San Antonio, TX 78232-1339
Phone
(210) 598-4236
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X Primary

Addresses

Primary practice location

1141 N Loop 1604 E # 105-446
San Antonio, TX 78232-1339

Mailing address

3206 Hilltop Ave
Muskogee, OK 74403-7764
Phone (405) 202-5455

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

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1225425689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 HILLTOP AVE",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744037764",
            "telephone_number": "405-202-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 N LOOP 1604 E # 105-446",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321339",
            "telephone_number": "210-598-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATEWOOD",
        "first_name": "AVERY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.