Active NPI
Jennifer Gilmore
- Surgical Technologist
- Covington, GA
National Provider Identifier
1760121404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 208984
- Practice address
- 4181 Hospital Dr NE
Covington, GA 30014-2541 - Phone
- (167) 843-6968
- NPI assigned
- Jun 1, 2022
- 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 |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 208984 | GA | Primary |
Addresses
Primary practice location
4181 Hospital Dr NE
Covington, GA 30014-2541
Mailing address
105 Cub LN
Covington, GA 30016-5874
Phone (784) 369-6806
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 208984 | GA | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654041600000",
"number": "1760121404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 CUB LN",
"city": "COVINGTON",
"state": "GA",
"postal_code": "300165874",
"telephone_number": "784-369-6806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4181 HOSPITAL DR NE",
"city": "COVINGTON",
"state": "GA",
"postal_code": "300142541",
"telephone_number": "167-843-6968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMORE",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-01",
"last_updated": "2022-06-01",
"certification_date": "2022-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "GA",
"license": "208984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.