Active NPI
Beatrice M Gaynor, NP
- Nurse Practitioner
- Newark, DE
National Provider Identifier
1730188467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- LG0000166
- Practice address
- 25 N College Ave
Newark, DE 19716-3799 - Phone
- (302) 831-3195
- Fax
- (302) 831-3193
- NPI assigned
- Jul 15, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | LG0000166 | DE | Primary |
Addresses
Primary practice location
25 N College Ave
Newark, DE 19716-3799
Mailing address
1275S State St
Dover, DE 19901-6927
Phone (302) 672-2319
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000033545 | Medicaid | DE |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LG0000166 | DE | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442188800000",
"number": "1730188467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1275S STATE ST",
"city": "DOVER",
"state": "DE",
"postal_code": "199016927",
"telephone_number": "302-672-2319",
"fax_number": "302-672-2341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 N COLLEGE AVE",
"city": "NEWARK",
"state": "DE",
"postal_code": "197163799",
"telephone_number": "302-831-3195",
"fax_number": "302-831-3193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYNOR",
"first_name": "BEATRICE",
"middle_name": "M",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-15",
"last_updated": "2015-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "DE",
"license": "LG0000166",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000033545",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.