Jon D Gerdsen, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5842 Issued in HI

Practice address

67-1123 Mamalahoa Hwy
Ste 128
Kamuela, HI 96743-8451

Phone

(808) 887-6460

Fax

(808) 887-6441

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962594887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67-1123 MAMALAHOA HWY",
            "address_2": "STE 128",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438451",
            "telephone_number": "808-887-6460",
            "fax_number": "808-887-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67-1123 MAMALAHOA HWY",
            "address_2": "STE 128",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438451",
            "telephone_number": "808-887-6460",
            "fax_number": "808-887-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERDSEN",
        "first_name": "JON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "5842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02481501",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dion Garcia, LMT
• Makala Elise Gardner, MS, RD, LD
• Cherylin Garvey, M.D.
• Katherine Gentile
• Tate Griffin Gentile, D.C.
• Yvonne Peggy Giron, LMT
• Amy Elizabeth Gordon, M.A. L.M.H.C. C.D.P.
• Melissa S Gosland, MD
• Monica Gotreau, M,A., BCBA
• Joan M Greco, DDS

• Pediatrics Physician in Kamuela, HI
• Providers in Kamuela, HI by specialty
• Pediatrics Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.