Active NPI
Keeley Omega Gilmore
- Community Health Worker
- Los Angeles, CA
National Provider Identifier
1629206172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 510 S Vermont Ave
Los Angeles, CA 90020-1912 - Phone
- (213) 947-6914
- NPI assigned
- Jun 23, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Day Training/Habilitation Specialist | 373H00000X | |||
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
510 S Vermont Ave
Los Angeles, CA 90020-1912
Mailing address
P O Box 92262
Long Beach, CA 90809
Phone (562) 338-0169
Other names 1
- Keely Gilmore
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1629206172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 92262",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90809",
"telephone_number": "562-338-0169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201912",
"telephone_number": "213-947-6914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMORE",
"first_name": "KEELEY",
"middle_name": "OMEGA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-23",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KEELY",
"last_name": "GILMORE",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.