Active NPI
Gina Nick Cushman, NMD
- Internal Medicine Physician
- Newport Beach, CA
National Provider Identifier
1396108130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ND-145
- Practice address
- 20072 SW Birch St
240
Newport Beach, CA 92660-0794 - Phone
- (949) 715-9321
- NPI assigned
- Mar 30, 2016
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ND-145 | CA | Primary |
Addresses
Primary practice location
20072 SW Birch St
240
Newport Beach, CA 92660-0794
Mailing address
20072 SW Birch St
240
Newport Beach, CA 92660-0794
Phone (949) 715-9321
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
| License | State | Type | Specialty |
|---|---|---|---|
| ND-145 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459296000000",
"number": "1396108130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20072 SW BIRCH ST",
"address_2": "240",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926600794",
"telephone_number": "949-715-9321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20072 SW BIRCH ST",
"address_2": "240",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926600794",
"telephone_number": "949-715-9321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUSHMAN",
"first_name": "GINA",
"middle_name": "NICK",
"credential": "NMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-30",
"last_updated": "2016-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "ND-145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.