KIM P GENDRON (NPI# 1053404061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053404061 |
| Entity Type | Individual |
| Full Name | KIM P GENDRON |
| Credential | FNP, NPP |
| Practice Address |
433 River St Ste 3000 Troy NY 12180-2250 |
| Mailing Address |
Po Box 14890 Albany NY 12212-4890 |
| Practice Telephone | 5182795700 |
| Practice Fax Number | 5182701323 |
| Mailing Telephone | 5185255634 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2019-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
331800 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
F401277 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | RR MEDICARE | P00466853 | 01 |
| NY | 02327719 | 05 |
| Street Address |
433 RIVER ST STE 3000 |
| City | TROY |
| State | NY |
| Zip Code | 12180-2250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295796092 | Aimee Isabelle Carlson | Nurse Practitioner | 433 River St Ste 3000, Troy, NY 12180-2250 | 2006-03-31 |
| 1285839878 | Miranda Lynn Dunham | Nurse Practitioner | 433 River St Ste 3000, Troy, NY 12180 | 2007-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528616232 | Gwendolyn Eve Guarino | Massage Therapist | Lux, 207 River St, Troy, NY 12180 | 2019-08-27 |
| 1568020857 | Shelby Mara Quintal | Counselor | 7 Collins Ave, Troy, NY 12180 | 2019-05-31 |
| 1881179646 | St. Peter's Health Partners Medical Associates, P.C. | Family Medicine | 2109 15th Street, Troy, NY 12180 | 2018-09-27 |
| 1104354315 | Karen Lynm Vincent | Licensed Practical Nurse | 830 Hoosick Rd Apt 1, Troy, NY 12180 | 2017-06-01 |
| 1740728013 | Upstate Physician Services, PC | Specialist | 2001 5th Avenue, Suite 110, Troy, NY 12180 | 2017-02-07 |
| 1205373263 | Tsu Han Poh | Pharmacist | 204 Washington Street, Apt C1, Troy, NY 12180 | 2017-01-27 |
| 1053760546 | Linda Pierre | Religious Nonmedical Nursing Personnel | 1680 Tibbits Ave, Troy, NY 12180 | 2016-06-06 |
| 1518312925 | Matthew Pittelli | Student in an Organized Health Care Education/Training Program | 83 Lockrow Rd, Troy, NY 12180 | 2016-05-04 |
| 1780045765 | Tara Michelle Miller | Hearing Instrument Specialist | 2000 6th Avenue, Troy Towers, Bldg. B, 1st Floor, Troy, NY 12180 | 2016-03-17 |
| 1326410937 | Seton Health System, Inc. | Physician Assistant | 1401 Massachusetts Avenue, Troy Internal Medicine, Troy, NY 12180 | 2015-10-22 |
| Find all providers in zip 12180 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998777 | Nila Ellison | Nurse Practitioner | 2810 Alisop Pl Apt 306, Troy, MI 48084-3470 | 2020-10-04 |
| 1689286262 | Kayla Dawn Metz | Nurse Practitioner | 101 Hunters Mountain Pkwy, Troy, AL 36079-5895 | 2020-08-17 |
| 1801421953 | Veronica Talevska | Nurse Practitioner | 1054 Henrietta Ave, Troy, MI 48083-1908 | 2020-03-10 |
| 1245878636 | Kim S Hussey | Nurse Practitioner | 989 Elba Hwy, Troy, AL 36079-6050 | 2019-12-16 |
| 1548804685 | Kelly N Lofton | Nurse Practitioner | 144 Prison Ln, Troy, VA 22974 | 2019-11-01 |
| 1740831528 | Monica Hallac | Nurse Practitioner | 3630 Old Creek Rd, Troy, MI 48084-1658 | 2019-09-24 |
| 1053961482 | Vian Murad | Nurse Practitioner | 752 Amberwood Dr, Troy, MI 48085-1676 | 2019-09-17 |
| 1245886100 | Sheila Kay Mitchell | Nurse Practitioner | 101 Hunter Mountain Parkway, Troy, AL 36081-3608 | 2019-08-15 |
| 1427510262 | Allison Michelle Harper | Nurse Practitioner | 3006 N County Road 25a Ste 102, Troy, OH 45373-1373 | 2019-04-02 |
| 1669940409 | Astasia C Goodenough | Nurse Practitioner | 5680 Wright Dr, Troy, MI 48098-2917 | 2018-11-09 |
| Find all providers in TROY | ||||
Please comment or provide details below to improve the information on KIM P GENDRON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.