Kim Gary Gauntt, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

DP00197 Issued in OR

Practice address

410 Villa Road
Newberg, OR 97132-1904

Phone

(503) 538-0466

Fax

(503) 538-0913

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• K G Gauntt DPM PC

  • Podiatrist
  • Newberg, OR
  • NPI 1275770349
  Medicare reassignment NPD Authorized official
• K G Gauntt DPM PC

  dba Foot Health Center of Newberg

  • Durable Medical Equipment & Medical Supplies
  • Newberg, OR
  • NPI 1366612376
  NPD Authorized official
• K. G. Gauntt D.P.M.

  dba Tuality Podiatry

  • Durable Medical Equipment & Medical Supplies
  • Newberg, OR
  • NPI 1871739482
  NPD (past)
• Ryan K Anderson D P M P C

  dba Foot & Ankle Specialists of Utah

  • Foot & Ankle Surgery Podiatrist
  • Bountiful, UT
  • NPI 1639200215
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Oregon

  dba Providence Newberg Medical Center

  • General Acute Care Hospital
  • Newberg, OR
  • NPI 1952482275
  Care Compare affiliation

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1902908171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 VILLA ROAD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321904",
            "telephone_number": "503-538-0466",
            "fax_number": "503-538-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 VILLA ROAD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321904",
            "telephone_number": "503-538-0466",
            "fax_number": "503-538-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUNTT",
        "first_name": "KIM",
        "middle_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001656",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Christine Garcia, PTA
• Shannan Garcia, LMT
• John Branden Garland, D.C., C.C.S.P.
• Daniel Garris
• Jenna Gaskin
• Alina Geller, DO
• Genesis Newberg Operation Co., LLC (Avamere at Newberg)
• George Fox University
• George Fox University
• George Fox University Physical Therapy Community Clinic

• Podiatrist in Newberg, OR
• Providers in Newberg, OR by specialty
• Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.