Active NPI
Kathryn Ann Giblin, M.D.
- Neurology Physician
- Waltham, MA
National Provider Identifier
1972828234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 258813
- Practice address
- 85 1St Ave
Waltham, MA 02451-1105 - Phone
- (781) 647-7246
- NPI assigned
- Mar 30, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | MD18374 | HI | |
| Neurology Physician | 2084N0400X | 258813 | MA | Primary |
| Interventional Pain Medicine Physician | 208VP0014X | 258813 | MA |
Addresses
Primary practice location
85 1St Ave
Waltham, MA 02451-1105
Mailing address
85 1St Ave
Waltham, MA 02451-1105
Phone (781) 647-7246
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD18374 | HI | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460592000000",
"number": "1972828234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 1ST AVE",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511105",
"telephone_number": "781-647-7246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 1ST AVE",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511105",
"telephone_number": "781-647-7246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBLIN",
"first_name": "KATHRYN",
"middle_name": "ANN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-30",
"last_updated": "2016-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "HI",
"license": "MD18374",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MA",
"license": "258813",
"primary": true
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "MA",
"license": "258813",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.