Active NPI
Gerald T Kilpatrick, MD
- Pediatrics Physician
- Brevard, NC
National Provider Identifier
1609917947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME0016099
- Practice address
- Free Medical Clinic
144 Duckworth Ave
Brevard, NC 28712 - Phone
- (828) 883-4454
- NPI assigned
- Feb 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME0016099 | FL | Primary |
Addresses
Primary practice location
Free Medical Clinic
144 Duckworth Ave
Brevard, NC 28712
Mailing address
22958 Drake LN
Summerland Key, FL 33042-4313
Phone (305) 745-4391
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0016099 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609917947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22958 DRAKE LN",
"city": "SUMMERLAND KEY",
"state": "FL",
"postal_code": "330424313",
"telephone_number": "305-745-4391",
"fax_number": "395-745-4391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "FREE MEDICAL CLINIC",
"address_2": "144 DUCKWORTH AVE",
"city": "BREVARD",
"state": "NC",
"postal_code": "28712",
"telephone_number": "828-883-4454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILPATRICK",
"first_name": "GERALD",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME0016099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brevard, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.