Individual provider Active NPI

Frederica Gilmore

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1851064570
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1046952 Issued in TX
Practice address
155 E Sonterra Blvd Ste 200
San Antonio, TX 78258-3989
Phone
(210) 593-5700
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 730629 TX
Family Nurse Practitioner 363LF0000X 1046952 TX Primary

Addresses

Primary practice location

155 E Sonterra Blvd Ste 200
San Antonio, TX 78258-3989

Mailing address

7710 W Interstate 10
San Antonio, TX 78230-4711
Phone (210) 377-3355

Other practice location 1

7710 W Interstate 10
San Antonio, TX 78230-4711
Phone (210) 377-3355

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

LicenseStateTypeSpecialty
730629TXMDRegistered Nurse
1046952TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1851064570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 W INTERSTATE 10",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782304711",
            "telephone_number": "210-377-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E SONTERRA BLVD STE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583989",
            "telephone_number": "210-593-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7710 W Interstate 10",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782304711",
            "country_code": "US",
            "telephone_number": "210-377-3355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "FREDERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "730629",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1046952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.