Individual provider Active NPI

Kristi Patricia Gill, D.O.

  • Neurology Physician
  • Boulder, CO
National Provider Identifier
1750514261
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0056978 Issued in CO
Practice address
2750 Broadway St
Boulder, CO 80304-3573
Phone
(303) 440-3216
Fax
(303) 440-3209
NPI assigned
Aug 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 101253 MT
Neurology Physician 2084N0400X OS021904 PA
Neurology Physician 2084N0400X 22102 NH
Neurology Physician 2084N0400X 0056978 CO Primary

Addresses

Primary practice location

2750 Broadway St
Boulder, CO 80304-3573

Mailing address

2750 Broadway St
Boulder, CO 80304-3573
Phone (303) 440-3216

Other practice location 1

630 Eaton Ave
Hamilton, OH 45013-2767
Phone (513) 867-2000

Other practice location 2

1250 S Cedar Crest Blvd Ste 405
Allentown, PA 18103-6224
Phone (610) 402-8420

Other practice location 3

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206
Phone (239) 208-2212

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Direct Messaging Address kgill766868@direct.ketteringhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, SC, NY, MS, OR, MI, NH, GA, IA9 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 9

Enrollment IDStateProvider typePAC IDDetails
I20181218002929 WA Practitioner - Neurology 6406080811 Reassigns benefits to 1 organization
I20210412001406 SC Practitioner - Neurology 6406080811
I20210616000875 NY Practitioner - Neurology 6406080811 Reassigns benefits to 3 organizations
I20211104000964 MS Practitioner - Neurology 6406080811 Reassigns benefits to 1 organization
I20211115000188 OR Practitioner - Neurology 6406080811 Reassigns benefits to 1 organization
I20211119000267 MI Practitioner - Neurology 6406080811 Reassigns benefits to 1 organization
I20211130003104 NH Practitioner - Neurology 6406080811 Reassigns benefits to 1 organization
I20211229002082 GA Practitioner - Neurology 6406080811 Reassigns benefits to 3 organizations
I20220323001905 IA Practitioner - Neurology 6406080811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
83462SCMDInternal Medicine Physician
0056978COMDNeurology Physician
101253MTMDNeurology Physician
22102NHMDNeurology Physician
OS021904PAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Inc Current Accepting new patients
Legacy Clinics LLC CurrentSince Oct 21, 2021 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince Feb 2, 2022 Accepting new patients
Lakeland Medical Practices CurrentSince Oct 17, 2021 Accepting new patients
Concord Hospital-Franklin Current Accepting new patients
Good Samaritan Hospital Medical CurrentSince Jun 1, 2021 Accepting new patients
North Mississippi Medical Center Inc. Neurology CurrentSince Sep 8, 2021 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Sep 1, 2021 Accepting new patients
St. Catherine of Siena Medical Center CurrentSince Jun 1, 2021 Accepting new patients
St Joseph Hospital of Nashua NH CurrentSince Jan 25, 2022 Accepting new patients
Legacy Clinics LLC CurrentSince Oct 21, 2021 Accepting new patients
St. Joseph Hospital CurrentSince Jun 1, 2021 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Sep 1, 2021 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince Feb 2, 2022 Accepting new patients
St Joseph Hospital of Nashua NH Current Accepting new patients
Upson County Hospital Inc Neurology CurrentSince Nov 22, 2021 Accepting new patients
Upson County Hospital Inc CurrentSince Nov 22, 2021 Accepting new patients
Concord Hospital-Laconia CurrentSince Jun 1, 2022 Accepting new patients
Piedmont Athens Hospitalist Physicians LLC CurrentSince Feb 2, 2022 Accepting new patients
Lakeland Medical Practices CurrentSince Oct 17, 2021 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Sep 8, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Piedmont Athens Specialty Care LLC Past Accepting new patients

Locations

11215 Metro Pkwy
Ste 1
Fort Myers, FL 33966
Phone (239) 208-2206

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

1800 10th Ave
Columbus, GA 31901
Phone (706) 571-1120

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

15 Aiken Ave
Franklin, NH 03235
Phone (603) 934-2060

80 Highland St
Laconia, NH 03246
Phone (603) 527-7100

238 Daniel Webster Hwy
Meredith, NH 03253
Phone (603) 279-7464

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Interoperability endpoints

  • Direct secure messaging: kgill391934@direct.peacehealth.org

Organizations & group practices 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1750514261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043573",
            "telephone_number": "303-440-3216",
            "fax_number": "303-440-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043573",
            "telephone_number": "303-440-3216",
            "fax_number": "303-440-3209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 Eaton Ave",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450132767",
            "country_code": "US",
            "telephone_number": "513-867-2000",
            "fax_number": "513-867-2119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 S Cedar Crest Blvd Ste 405",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036224",
            "country_code": "US",
            "telephone_number": "610-402-8420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11215 Metro Pkwy Ste 1",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339661206",
            "country_code": "US",
            "telephone_number": "239-208-2212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "KRISTI",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MT",
            "license": "101253",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "OS021904",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NH",
            "license": "22102",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "0056978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgill766868@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.