Individual provider Active NPI

Kristin Gemmill, CRNA

  • Pediatric Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1275061665
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
RN2264094 Issued in MA
Practice address
300 Longwood Ave
Boston, MA 02115-5724
Phone
(617) 358-4632
NPI assigned
May 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X RN2264094 MA Primary

Addresses

Primary practice location

300 Longwood Ave
Boston, MA 02115-5724

Mailing address

6 Columbus SQ Unit 4
Boston, MA 02116-5978
Phone (978) 808-2787

Other practice location 1

77 Wolcott Ave Ste 105
Dartmouth, MA 02747-2459
Phone (800) 521-2776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171019002666 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345516217 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2264094MAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHMC Anesthesia Foundation Inc Pediatric Anesthesiology CurrentSince Aug 22, 2017 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

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": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1275061665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 COLUMBUS SQ UNIT 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165978",
            "telephone_number": "978-808-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-358-4632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Wolcott Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Dartmouth",
            "state": "MA",
            "postal_code": "027472459",
            "country_code": "US",
            "telephone_number": "800-521-2776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEMMILL",
        "first_name": "KRISTIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MA",
            "license": "RN2264094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.