Individual provider Active NPI

Gabrielle Thelma-Rose O'Gorman, RD

  • Registered Dietitian
  • Miami, FL
National Provider Identifier
1609608561
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86265235 Issued in SC
Practice address
255 SW 11TH St Apt 1001
Miami, FL 33130-4190
Phone
(814) 441-5177
NPI assigned
Aug 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86265235 SC Primary

Addresses

Primary practice location

255 SW 11TH St Apt 1001
Miami, FL 33130-4190

Mailing address

255 SW 11TH St Apt 1001
Miami, FL 33130-4190
Phone (814) 441-5177

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
86265235SCMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1609608561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SW 11TH ST APT 1001",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331304190",
            "telephone_number": "814-441-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 SW 11TH ST APT 1001",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331304190",
            "telephone_number": "814-441-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'GORMAN",
        "first_name": "GABRIELLE",
        "middle_name": "THELMA-ROSE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "86265235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.