Individual provider Active NPI

Christy Diane Gilmer, APRN

  • Gerontology Nurse Practitioner
  • Kerrville, TX
National Provider Identifier
1811531817
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0000000 Issued in TX
Practice address
250 Cully Dr
Kerrville, TX 78028-5950
Phone
(830) 258-6300
Fax
(830) 515-5485
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0000000 TX Primary

Addresses

Primary practice location

250 Cully Dr
Kerrville, TX 78028-5950

Mailing address

250 Cully Dr
Kerrville, TX 78028-5950
Phone (830) 258-6300

Other identifiers 1

IdentifierTypeStateIssuer
405694701MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191230001897 TX Practitioner - Nurse Practitioner 8224462155 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0000000TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Peterson Medical Associates CurrentSince Dec 9, 2019 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Aug 1, 2021 Accepting new patients
Southcentral Foundation Past Accepting new patients

Locations

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

551 Hill Country Dr
Kerrville, TX 78028
Phone (830) 257-5414

823 Junction Hwy
Kerrville, TX 78028
Phone (830) 258-6300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1811531817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CULLY DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285950",
            "telephone_number": "830-258-6300",
            "fax_number": "830-515-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CULLY DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285950",
            "telephone_number": "830-258-6300",
            "fax_number": "830-515-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMER",
        "first_name": "CHRISTY",
        "middle_name": "DIANE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "0000000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405694701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kerrville, TX

Sources for this page

Verify at the official NPI Registry.