Active NPI
Gary Shimotsu, M.D.
- Internal Medicine Physician
- Kerrville, TX
National Provider Identifier
1780696906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- F2000
- Practice address
- 3600 Memorial Blvd
Medical Staff Office
Kerrville, TX 78028-5768 - Phone
- (830) 896-2020
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | F2000 | TX | Primary |
Addresses
Primary practice location
3600 Memorial Blvd
Medical Staff Office
Kerrville, TX 78028-5768
Mailing address
PO Box 781855
San Antonio, TX 78278-1855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131004000260 | TX | Order and Referring Only - Internal Medicine | 5799919759 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441670400000",
"number": "1780696906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 781855",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782781855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 MEMORIAL BLVD",
"address_2": "MEDICAL STAFF OFFICE",
"city": "KERRVILLE",
"state": "TX",
"postal_code": "780285768",
"telephone_number": "830-896-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMOTSU",
"first_name": "GARY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2015-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "F2000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kerrville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.