Kelly Maureen Gdovic, W.H.N.P.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

0024116360 Issued in VA

Practice address

11842 Rock Landing Dr Ste 115
Newport News, VA 23606-4437

Phone

(757) 595-9905

Fax

(757) 595-5377

NPI assigned

Jun 19, 2007

Last updated

May 14, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1538364583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11842 ROCK LANDING DR STE 115",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064437",
            "telephone_number": "757-595-9905",
            "fax_number": "757-595-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11842 ROCK LANDING DR STE 115",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064437",
            "telephone_number": "757-595-9905",
            "fax_number": "757-595-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GDOVIC",
        "first_name": "KELLY",
        "middle_name": "MAUREEN",
        "name_prefix": "Ms.",
        "credential": "W.H.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024116360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0024116360",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Women's Health Nurse Practitioner in Newport News, VA
• Providers in Newport News, VA by specialty
• Women's Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.