Active NPI
Michael L Gilmore, CRNA
- Certified Registered Nurse Anesthetist
- Sioux Falls, SD
National Provider Identifier
1497729792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0029
- Practice address
- 1305 W 18TH St
Sioux Falls, SD 57105-0401 - Phone
- (605) 333-1000
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 0029 | SD | Primary |
Addresses
Primary practice location
1305 W 18TH St
Sioux Falls, SD 57105-0401
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6548
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5752730 | Medicaid | SD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1497729792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074",
"telephone_number": "605-328-6548",
"fax_number": "605-328-6512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 W 18TH ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571050401",
"telephone_number": "605-333-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMORE",
"first_name": "MICHAEL",
"middle_name": "L",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "SD",
"license": "0029",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5752730",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.