Individual provider Active NPI

Kathryne Gunn, DO

  • General Practice Physician
  • Cocoa Beach, FL
National Provider Identifier
1346773926
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15963 Issued in FL
Practice address
6740 Ridgewood Ave
Cocoa Beach, FL 32931-4054
Phone
(321) 368-7744
NPI assigned
Apr 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 15963 FL Primary

Addresses

Primary practice location

6740 Ridgewood Ave
Cocoa Beach, FL 32931-4054

Mailing address

6740 Ridgewood Ave
Cocoa Beach, FL 32931-4054
Phone (321) 368-7744

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220426001063 FL Practitioner - Family Practice 9739450586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lincoln Memorial University Medical Department, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellness One Chiropractic LLCGroup PAC ID 1951478858, 2 clinicians

Practice addresses (Care Compare)

2 Office Park Dr
Suite a
Palm Coast, FL 32137-3859
Phone (386) 447-9930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15963FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness One Chiropractic LLC CurrentSince Apr 20, 2022 Accepting new patients

Locations

2 Office Park Dr
Ste A
Palm Coast, FL 32137
Phone (386) 447-9930

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1346773926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6740 RIDGEWOOD AVE",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329314054",
            "telephone_number": "321-368-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6740 RIDGEWOOD AVE",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329314054",
            "telephone_number": "321-368-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNN",
        "first_name": "KATHRYNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2021-06-02",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "15963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa Beach, FL

Sources for this page

Verify at the official NPI Registry.