Gaile Kristine Philipp

Primary specialty

OptometristTaxonomy code 152W00000X

License

3246 Issued in MN

Practice address

3001 White Bear Ave N Ste 1050
Saint Paul, MN 55109-1283

Phone

(651) 770-3923

Fax

(651) 770-5316

NPI assigned

Oct 7, 2009

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

Other identifiers 1

Other names 1

• Gaile Kristine Ourada Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: gphilipp1540@gracevisioninc.emadirect.md

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740515832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 WHITE BEAR AVE N STE 1050",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091283",
            "telephone_number": "651-770-3923",
            "fax_number": "651-770-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 WHITE BEAR AVE N STE 1050",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551091283",
            "telephone_number": "651-770-3923",
            "fax_number": "651-770-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIPP",
        "first_name": "GAILE",
        "middle_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA OPTOMETRIC LICENSE",
            "identifier": "3246",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAILE",
            "last_name": "OURADA",
            "middle_name": "KRISTINE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Phyllis White Phelan, PH.D.
• Phenomix Sciences LLC
• Khammany Phetsavong
• Chanhderg Philavanh
• Ann M Philbrick, PHARM.D.
• Brianna Phillips, RDN, LD
• Clayton Thaddeus Rudolf Phillips, LADC
• Jessie Phillips
• Kester A Phillips, MD
• Sara Meconis Phillips, LICSW

• Optometrist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.