Active NPI
Regina Sue Gim, PHARM.D.
- Pharmacist
- Fort Gordon, GA
National Provider Identifier
1285225177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH030652
- Practice address
- 300 W Hospital Rd
Fort Gordon, GA 30905-5741 - Phone
- (706) 787-2776
- NPI assigned
- Feb 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH030652 | GA | Primary |
Addresses
Primary practice location
300 W Hospital Rd
Fort Gordon, GA 30905-5741
Mailing address
300 W Hospital Rd
Eisenhower Army Medical Center Attn Credentials
Fort Gordon, GA 30905-5741
Phone (678) 925-5736
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH030652 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1285225177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W HOSPITAL RD",
"address_2": "EISENHOWER ARMY MEDICAL CENTER ATTN CREDENTIALS",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055741",
"telephone_number": "678-925-5736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W HOSPITAL RD",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309055741",
"telephone_number": "706-787-2776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIM",
"first_name": "REGINA",
"middle_name": "SUE",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-02",
"last_updated": "2023-02-13",
"certification_date": "2023-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH030652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.