Gwendolyn G Gavino, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

052069 Issued in GA

Practice address

7211 W Deschutes Ave
Ste. E
Kennewick, WA 99336-7728

Phone

(509) 735-9239

Fax

(509) 735-9310

NPI assigned

Mar 2, 2006

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

Other identifiers 2

Other names 1

• Gwendolyn Y Gatmaitan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: gwendolyn.gavino.1@18485.direct.athenahealth.com

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.

• Kennewick Public Hospital District

  • Home Health Agency
  • Kennewick, WA
  • NPI 1184797433
  NPD (past)
• Kennewick Public Hospital District

  • Multi-Specialty Clinic/Center
  • Kennewick, WA
  • NPI 1235257262
  NPD (past)

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1235106808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7203 W DESCHUTES AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367777",
            "telephone_number": "509-737-1880",
            "fax_number": "509-737-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 W DESCHUTES AVE",
            "address_2": "STE. E",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367728",
            "telephone_number": "509-735-9239",
            "fax_number": "509-735-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVINO",
        "first_name": "GWENDOLYN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "052069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000971022A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000971022B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWENDOLYN",
            "last_name": "GATMAITAN",
            "middle_name": "Y",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maurilio C. Garza, LMHC
• Meegan V Garza, RN
• Tammy A Garza, LMT
• Shannon E Gatrell, O.D.
• Deleon Gause, BA
• Ma Hazel Lyn Gutierrez Gavino, MD
• Roman R Gavino, MD
• Susan Gazewood
• Patrick Brian Geagon II
• Sharon Gentry

• Pediatrics Physician in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.