Active NPI
Georgette Fernanda Gura, CPNP
- Pediatric Nurse Practitioner
- Raleigh, NC
National Provider Identifier
1417129305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 300235
- Practice address
- 5904 Six Forks Rd
Ste 111
Raleigh, NC 27609-8228 - Phone
- (919) 787-9555
- Fax
- (919) 510-5111
- NPI assigned
- Mar 31, 2008
- Last updated
- Mar 28, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 300235 | NC | Primary |
Addresses
Primary practice location
5904 Six Forks Rd
Ste 111
Raleigh, NC 27609-8228
Mailing address
5904 Six Forks Rd
Ste 111
Raleigh, NC 27609-8228
Phone (919) 787-9555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7003676 | Medicaid | NC |
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)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300235 | NC | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shelby Pediatric Associates and Child Lung Center PC | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- georgette.gura.1@7131.direct.athenahealth.com
Organizations & group practices 2
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.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Pediatrics Physician
- Shelby Township, MI
- NPI 1124051990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522195200000",
"number": "1417129305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5904 SIX FORKS RD",
"address_2": "STE 111",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276098228",
"telephone_number": "919-787-9555",
"fax_number": "919-510-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5904 SIX FORKS RD",
"address_2": "STE 111",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276098228",
"telephone_number": "919-787-9555",
"fax_number": "919-510-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GURA",
"first_name": "GEORGETTE",
"middle_name": "FERNANDA",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-31",
"last_updated": "2018-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NC",
"license": "300235",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7003676",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.