John S. Gilliam, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

41469 Issued in AZ

Practice address

20172 E Stagecoach TRL
Mayer, AZ 86333-2357

Phone

(800) 288-6206

Fax

(800) 960-4547

NPI assigned

Mar 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OK, AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Oral Roberts University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carelock LLCGroup PAC ID 9436491172, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.25 of 100Reported as group

Quality

82.35

Improvement activities

40

Cost

75.39

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ABJGBD
• FHIR API: https://fhir4.healow.com/fhir/r4/ABJGBD/Endpoint/ABJGBD

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.

• Carelock, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1245795459
  Medicare reassignment Care Compare group NPD Authorized official
• Carelock, LLC

  • Urgent Care Clinic/Center
  • Chino Valley, AZ
  • NPI 1366181703
  NPD Authorized official
• Carelock, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mayer, AZ
  • NPI 1972170322
  NPD Authorized official
• Asura Healthcare LLC

  • Family Medicine Physician
  • Dewey, AZ
  • NPI 1669991485
  NPD (past) Authorized official
• Shamrock Recovery Services LLC.

  • Community/Behavioral Health Agency
  • Prescott, AZ
  • NPI 1659035137

  Family Medicine

  NPD
• Bellezza Sensa LLC

  • Women's Health Nurse Practitioner
  • Prescott, AZ
  • NPI 1215170485
  NPD (past)
• Mercy Health Services Inc.

  • Medical Specialty Clinic/Center
  • Yukon, OK
  • NPI 1255398251
  NPD (past)

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1003877085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15029 N THOMPSON PEAK PARKWAY",
            "address_2": "STE B-111 PMB 438",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602223",
            "telephone_number": "405-590-8861",
            "fax_number": "800-960-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20172 E STAGECOACH TRL",
            "city": "MAYER",
            "state": "AZ",
            "postal_code": "863332357",
            "telephone_number": "800-288-6206",
            "fax_number": "800-960-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "JOHN",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "16226",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "41469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100044450B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS (ARIZONA MEDICAID) ID",
            "identifier": "600874",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z144938",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100044450A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Mayer, AZ
• Providers in Mayer, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.