Individual provider Active NPI

Gabrielle Miladore

  • Pediatric Nurse Practitioner
  • Boardman, OH
National Provider Identifier
1851042303
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0029628 Issued in OH
Practice address
6505 Market St BLDG a
Boardman, OH 44512-3457
Phone
(330) 746-8100
NPI assigned
Jan 17, 2022
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0029628 OH Primary

Addresses

Primary practice location

6505 Market St BLDG a
Boardman, OH 44512-3457

Mailing address

526 Berklee Dr
Youngstown, OH 44514-3596

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0029628OHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Akron Children's Hospital Current Accepting new patients
Children's Hospital Medical Center of Akron PastSince Jan 26, 2022 Accepting new patients
Children's Hospital Medical Center of Akron Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ganderson26185@direct.chmca.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1851042303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 BERKLEE DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445143596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 MARKET ST BLDG A",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445123457",
            "telephone_number": "330-746-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILADORE",
        "first_name": "GABRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "0029628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.

Verify at the official NPI Registry.