Adam Gault, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

59581 Issued in ID

Practice address

500 S 11TH Ave
Pocatello, ID 83201-4835

Phone

(208) 232-6214

NPI assigned

Aug 7, 2018

Last updated

Nov 21, 2018By the provider in NPPES

Sex

Male

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 ID

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1700365178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014835",
            "telephone_number": "208-232-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014835",
            "telephone_number": "208-232-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAULT",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "59581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Renee Gault, DNP, PMHNP-BC
• Lorri D Gebo-Shaver, PHARMD
• Bryan Mark Gee, OTR/L, MS, OTD
• Cydnee L Gee, OTL
• Gem Prep: Pocatello, LLC

• Family Nurse Practitioner in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.