Gillette Internal Medicine Associates PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GILLETTE INTERNAL MEDICINE ASSOCIATES PC

Practice address

407 S Medical Arts CT
Suite D
Gillette, WY 82716-3372

Phone

(307) 682-0400

Fax

(307) 686-7420

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Kirtikumar L Patel, MD

Title

President

Phone

(307) 682-0400

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497841548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S MEDICAL ARTS CT",
            "address_2": "SUITE D",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163372",
            "telephone_number": "307-682-0400",
            "fax_number": "307-686-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S MEDICAL ARTS CT",
            "address_2": "SUITE D",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163372",
            "telephone_number": "307-682-0400",
            "fax_number": "307-686-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILLETTE INTERNAL MEDICINE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KIRTIKUMAR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-682-0400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113341100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Logan George, MD
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• All providers in Gillette, WY
• Internal Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.