Active NPI
Stephanie Gilmore, PT, DPT
- Physical Therapist
- Hermosa Beach, CA
National Provider Identifier
1689082091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 41429
- Practice address
- 415 Herondo St Apt 341
Hermosa Beach, CA 90254-5518 - Phone
- (405) 919-7281
- NPI assigned
- Jul 29, 2014
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 41429 | CA | Primary |
| Physical Therapist | 225100000X | 19883 | MA |
Addresses
Primary practice location
415 Herondo St Apt 341
Hermosa Beach, CA 90254-5518
Mailing address
415 Herondo St Apt 341
Hermosa Beach, CA 90254-5518
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
| License | State | Type | Specialty |
|---|---|---|---|
| 41429 | CA | MD | General Practice Dentistry |
| 19883 | MA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406592000000",
"number": "1689082091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 HERONDO ST APT 341",
"city": "HERMOSA BEACH",
"state": "CA",
"postal_code": "902545518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 HERONDO ST APT 341",
"city": "HERMOSA BEACH",
"state": "CA",
"postal_code": "902545518",
"telephone_number": "405-919-7281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMORE",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-29",
"last_updated": "2014-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "41429",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "19883",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hermosa Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.