Individual provider Active NPI

Kelly Gill

  • Family Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1487078879
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014000693 Issued in MO
Practice address
1 California St Ste 2300
San Francisco, CA 94111-5424
Phone
(800) 997-6196
Fax
(415) 504-1367
NPI assigned
Feb 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2014000693 MO Primary

Addresses

Primary practice location

1 California St Ste 2300
San Francisco, CA 94111-5424

Mailing address

1 California St Ste 2300
San Francisco, CA 94111-5424
Phone (800) 997-6196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140320001647 MO Practitioner - Nurse Practitioner 5193956944 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Kansas City, School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medicine - SLMG South LLCGroup PAC ID 3971833443, 12 clinicians

Practice addresses (Care Compare)

103 Hilltop TRL
Eureka, MO 63025-3172
Phone (636) 587-6350

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine - SLMG South, LLC Family Medicine CurrentSince May 1, 2025 Accepting new patients
Premier Medical Physicians LLC Family Medicine CurrentSince Jun 1, 2025 Accepting new patients
St. Lukes Medical Group Family Medicine Past Accepting new patients

Locations

121 Saint Lukes Center Dr
Chesterfield, MO 63017
Phone (314) 434-3278

12304 Manchester Rd
Des Peres, MO 63131
Phone (314) 965-6871

103 Hilltop Village Center Dr
Eureka, MO 63025
Phone (314) 576-9797

1501 Professional Dr
Imperial, MO 63052
Phone (636) 464-4000

2325 Dougherty Ferry Rd
Ste 104
Saint Louis, MO 63122
Phone (314) 821-6889

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1487078879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CALIFORNIA ST STE 2300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115424",
            "telephone_number": "800-997-6196",
            "fax_number": "415-504-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CALIFORNIA ST STE 2300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115424",
            "telephone_number": "800-997-6196",
            "fax_number": "415-504-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-06",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014000693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.