Individual provider Active NPI

Elizabeth Kelly Gause, DMD

  • General Practice Dentistry
  • Gainesville, FL
National Provider Identifier
1982196010
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN23369 Issued in FL
Practice address
1010 NW 76TH Blvd
Gainesville, FL 32606-6747
Phone
(523) 332-4180
NPI assigned
Jun 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN23369 FL Primary

Addresses

Primary practice location

1010 NW 76TH Blvd
Gainesville, FL 32606-6747

Mailing address

2117 SW 102ND Ter
Gainesville, FL 32607-3254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20180924001184 FL Order and Referring Only - DentistPractitioner - Dentist 5294086732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN23369FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Wildwood Dentists, PA General Practice Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1982196010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 SW 102ND TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326073254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 NW 76TH BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066747",
            "telephone_number": "523-332-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUSE",
        "first_name": "ELIZABETH",
        "middle_name": "KELLY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.