Kadeidre La'Trell Gaymon

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

249257 Issued in SC

Practice address

6439 Garners Ferry Rd
Columbia, SC 29209-1638

Phone

(803) 920-6625

NPI assigned

Aug 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1891460853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 LIBERTY RIDGE DR",
            "city": "ELGIN",
            "state": "SC",
            "postal_code": "290457905",
            "telephone_number": "803-920-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6439 GARNERS FERRY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091638",
            "telephone_number": "803-920-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYMON",
        "first_name": "KADEIDRE",
        "middle_name": "LA'TRELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "249257",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "SC",
            "license": "249257",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "SC",
            "license": "249257",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "SC",
            "license": "249257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "PVF908740801",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kadeidregaymon@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "286 Liberty Ridge Dr",
            "city": "Elgin",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290457905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Nicole Gatto
• Hadyn Stands Gause, NP
• Kartina Gause, RN
• Robert Gauthier
• William H Gaw Jr., NP
• GD SC Columbia, LLC
• David Gearding Jr., DO
• Shannon Leigh Gearhart, M.D.
• Cindy Irene Gearheart, APRN, FNP-C
• Anwar Gebremichael, DDS

• Critical Care Medicine Registered Nurse in Columbia, SC
• Providers in Columbia, SC by specialty
• Critical Care Medicine Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.