Kim R Cantwell-Gab, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

201503207NP-PP Issued in OR

Practice address

1698 E McAndrews Rd
Suite 300
Medford, OR 97504-5589

Phone

(541) 732-7850

NPI assigned

Jul 16, 2007

Last updated

Sep 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: kcantwellgab735513@oc.providencedirect.org

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1962601310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR",
            "address_2": "STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044314",
            "telephone_number": "541-732-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 E MCANDREWS RD",
            "address_2": "SUITE 300",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045589",
            "telephone_number": "541-732-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTWELL-GAB",
        "first_name": "KIM",
        "middle_name": "R",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30007760",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201503207NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcantwellgab735513@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1698 E McAndrews Rd",
            "address_2": "Suite 300",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975045589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer L Canganelli, R.D., C.D.E.
• Peter Canning, M.D.
• Christopher E Cannon, MD
• Jennifer Cannon
• Steven Gregory Cannon, MD
• Camille Canty-Fischer, LCSW, CADC I
• Caroline Capitano, DO
• Thomas Capsey, DMD
• Miguel G Carbonell, MD
• Rafael Eduardo Cardenas Castillo, MD

• Nurse Practitioner in Medford, OR
• Providers in Medford, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.