Individual provider Active NPI

William Allen Gillespie, MD

  • Pediatrics Physician
  • Durham, CT
National Provider Identifier
1013343334
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
037591 Issued in CT
Practice address
256 Main St
Durham, CT 06422
Phone
(860) 349-9434
NPI assigned
Sep 18, 2013
Last updated
Sep 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 037591 CT Primary
Pediatrics Physician 208000000X 7879548 NY

Addresses

Primary practice location

256 Main St
Durham, CT 06422

Mailing address

256 Main St
Durham, CT 06422
Phone (860) 349-9434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220831003880 CT Practitioner - Pediatric Medicine 0143132233 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
037591CTMDPediatrics Physician
7879548NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charter Oak Health Center, Inc. CurrentSince Aug 18, 2022 Accepting new patients
Charter Oak Health Center, Inc. CurrentSince Aug 18, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc PastSince Mar 1, 1999 Accepting new patients

Locations

21 Grand St
Hartford, CT 06106

Interoperability endpoints

  • Direct secure messaging: william.gillespie@cohc.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1013343334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 MAIN ST",
            "city": "DURHAM",
            "state": "CT",
            "postal_code": "06422",
            "telephone_number": "860-349-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 MAIN ST",
            "city": "DURHAM",
            "state": "CT",
            "postal_code": "06422",
            "telephone_number": "860-349-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "WILLIAM",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-18",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "037591",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "7879548",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, CT

Sources for this page

Verify at the official NPI Registry.