Laura Elizabeth Korthauer Gilmour, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PS01797 Issued in RI

Practice address

110 Lockwood St Ste 430
Providence, RI 02903-4815

Phone

(401) 444-7735

NPI assigned

Jun 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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

• Lifespan Physician Group, Inc.

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793

  Clinical Neuropsychologist

  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1689299661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LOCKWOOD ST STE 430",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LOCKWOOD ST STE 430",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034815",
            "telephone_number": "401-444-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTHAUER GILMOUR",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "RI",
            "license": "PS01797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Korbly, MD
• Gideon Koren, M.D.
• Elisabeth Kornblee, LICSW
• Kenneth S Korr, MD
• Inga Korsgaard, PHD
• Molyneat Kosal
• Chirene Kosseifi
• Stefan G Kostadinov, MD
• Michael Philip Koster, M.D.
• Nikita Kostrubsky, MD

• Clinical Neuropsychologist in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Neuropsychologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.