Individual provider Active NPI

John C Gilmore Jr., D.M.D.

  • General Practice Dentistry
  • Pensacola, FL
National Provider Identifier
1265460414
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6371 Issued in FL
Practice address
1759 Creighton Rd
Pensacola, FL 32504-7145
Phone
(850) 476-4283
Fax
(850) 476-9709
NPI assigned
Jun 28, 2006
Last updated
Jun 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6371 FL Primary
General Practice Dentistry 1223G0001X 15660 FL

Addresses

Primary practice location

1759 Creighton Rd
Pensacola, FL 32504-7145

Mailing address

1759 Creighton Rd
Pensacola, FL 32504-7145
Phone (850) 476-4283

Other identifiers 1

IdentifierTypeStateIssuer
789977OtherUNITED CONCORDIA PROVIDER

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
15660FLMDGeneral Practice Dentistry
6371FLMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
John C. Gilmore, Jr., D.M.D., P.a. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1265460414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1759 CREIGHTON RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047145",
            "telephone_number": "850-476-4283",
            "fax_number": "850-476-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759 CREIGHTON RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047145",
            "telephone_number": "850-476-4283",
            "fax_number": "850-476-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "6371",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "15660",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "789977",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.