Active NPI
Suzanne Gilmore, APRN
- Family Nurse Practitioner
- Ashland, KY
National Provider Identifier
1760438865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 3004090
- Practice address
- 2201 Lexington Ave
Ashland, KY 41101-2843 - Phone
- (606) 408-4000
- NPI assigned
- May 26, 2006
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3004090 | KY | Primary |
Addresses
Primary practice location
2201 Lexington Ave
Ashland, KY 41101-2843
Mailing address
PO Box 1595
Ashland, KY 41105-1595
Phone (606) 408-6200
Other practice location 1
609 N Carol Malone Blvd Ste 105
Grayson, KY 41143-1123
Phone (606) 474-2235
Other practice location 2
613 23rd St Ste 230
Ashland, KY 41101-2868
Phone (606) 324-4745
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78010402 | Medicaid | KY | |
| P01386217 | Other | KY | RR MEDICARE |
| 2648997 | Medicaid | OH |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536710400000",
"number": "1760438865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1595",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411051595",
"telephone_number": "606-408-6200",
"fax_number": "606-408-6612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 LEXINGTON AVE",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411012843",
"telephone_number": "606-408-4000"
}
],
"practiceLocations": [
{
"address_1": "609 N Carol Malone Blvd Ste 105",
"address_purpose": "LOCATION",
"city": "Grayson",
"state": "KY",
"postal_code": "411431123",
"country_code": "US",
"telephone_number": "606-474-2235",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "613 23rd St Ste 230",
"address_purpose": "LOCATION",
"city": "Ashland",
"state": "KY",
"postal_code": "411012868",
"country_code": "US",
"telephone_number": "606-324-4745",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GILMORE",
"first_name": "SUZANNE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2018-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3004090",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78010402",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01386217",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2648997",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.