Active NPI
Lorraine Gill, R.D.
- Registered Dietitian
- Kotzebue, AK
National Provider Identifier
1235333246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164
- Practice address
- 5TH & Ted Stevens Way
Kotzebue, AK 99752 - Phone
- (907) 442-7212
- NPI assigned
- Jun 13, 2007
- Last updated
- Apr 20, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164 | AK | Primary |
Addresses
Primary practice location
5TH & Ted Stevens Way
Kotzebue, AK 99752
Mailing address
PO Box 521
Kotzebue, AK 99752-0521
Phone (907) 412-2980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DT6472 | Medicaid | AK |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164 | AK | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429488000000",
"number": "1235333246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 521",
"city": "KOTZEBUE",
"state": "AK",
"postal_code": "997520521",
"telephone_number": "907-412-2980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5TH & TED STEVENS WAY",
"city": "KOTZEBUE",
"state": "AK",
"postal_code": "99752",
"telephone_number": "907-442-7212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILL",
"first_name": "LORRAINE",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-13",
"last_updated": "2015-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AK",
"license": "164",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DT6472",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kotzebue, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.