KELLY DAVID GAGE M.D. NPI 1356324370

NPI Information

NPI: 1356324370
Provider Name: KELLY DAVID GAGE, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Organization: PENINSULA RADIOLOGICAL ASSOCIATES LTD

PECOS Registration: Yes

Address:
618 HOSPITAL ROAD
RIVERSIDE TAPPAHANNOCK HOSPITAL
TAPPAHANNOCK, VA
ZIP 22560
Phone: (804) 443-6044
Get Directions

Kelly David Gage, M.D. is a diagnostic radiology radiology in Tappahannock, VA with 25 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Kelly David Gage, M.D. NPI is 1356324370. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

618 HOSPITAL ROAD
RIVERSIDE TAPPAHANNOCK HOSPITAL
TAPPAHANNOCK, VA
ZIP 22560-000
Phone: (804) 443-6044
Fax: (757) 867-7547

The NPI 1356324370 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/23/2005 and was last updated on 11/8/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	01053434A	INDIANA	No
2	2085R0202X	Radiology	Diagnostic Radiology	0101242665	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1356324370	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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