Kimberly Ann Gush, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2005-00670 Issued in NC

Practice address

300 Market St Ste 112
Chapel Hill, NC 27516-4493

Phone

(919) 969-9611

Fax

(919) 969-9615

NPI assigned

Jul 20, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Village Pediatrics of Chapel Hill, PA

  • Pediatrics Physician
  • Chapel Hill, NC
  • NPI 1578650735
  NPD

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1306845565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MARKET ST STE 112",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275164493",
            "telephone_number": "919-969-9611",
            "fax_number": "919-969-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MARKET ST STE 112",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275164493",
            "telephone_number": "919-969-9611",
            "fax_number": "919-969-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSH",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2005-00670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902692",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gaorav Pankaj Gupta, M.D., PH.D.
• Jyotsna J Gupta
• Savita Gupta
• Marco Shane Gupton, DO
• Maureen Gupton
• Erik Jonathan Gustke, M.D.
• Catherine Baker Guthrie, MSPT
• Joseph Guthrie, P.A.
• Karson Olivia Guthrie, PHARMD
• Sophia Alperin Gutterman

• Pediatrics Physician in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.