Individual provider Active NPI

Krystle Gish, DO

  • Family Medicine Physician
  • Bradenton, FL
National Provider Identifier
1669096335
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20273 Issued in FL
Practice address
3007 Manatee Ave W
Bradenton, FL 34205-4240
Phone
(941) 748-8069
Fax
(941) 748-6609
NPI assigned
May 29, 2020
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20273 FL Primary
Family Medicine Physician 207Q00000X 5151014419 MI

Addresses

Primary practice location

3007 Manatee Ave W
Bradenton, FL 34205-4240

Mailing address

3007 Manatee Ave W
Bradenton, FL 34205-4240
Phone (941) 748-8069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231009003076 FL Practitioner - Family Practice 6002261260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Care Group IncGroup PAC ID 2668704875, 6 clinicians

Practice addresses (Care Compare)

3007 Manatee Ave W
Bradenton, FL 34205-4240
Phone (631) 889-1442

3303 Manatee Ave W
Bradenton, FL 34205-2550

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20273FLMDFamily Medicine Physician
5151014419MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Care Group Inc Single Specialty CurrentSince Oct 1, 2023 Accepting new patients

Locations

3007 Manatee Ave W
Bradenton, FL 34205
Phone (631) 889-1442

3303 Manatee Ave W
Bradenton, FL 34205
Phone (941) 324-2550

3303 Manatee Ave W
Unit A
Bradenton, FL 34205

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1669096335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054240",
            "telephone_number": "941-748-8069",
            "fax_number": "941-748-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054240",
            "telephone_number": "941-748-8069",
            "fax_number": "941-748-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GISH",
        "first_name": "KRYSTLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "20273",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151014419",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.