Mary Beth Gilliam, PT, DPT, MS, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT019270 Issued in OH

Practice address

3200 Vine St
Cincinnati, OH 45220-2213

Phone

(513) 861-3100

NPI assigned

Jun 26, 2021

Last updated

Nov 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Orthocincy Orthopaedics & Sports Medicine PSC

  • Orthopaedic Surgery Physician
  • Edgewood, KY
  • NPI 1598714560

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1033789748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 VINE ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202213",
            "telephone_number": "513-861-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 VINE ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202213",
            "telephone_number": "513-861-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "PT, DPT, MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-26",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT019270",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT003489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parker Dane Gillespie, PA-C
• Jordan Gillette
• Lauren Michelle Gilley, PT
• Courtney Ann Gilliam
• Mary Gilliam
• Sheila Louise Gilliam
• Shasta Gilliard
• Shawn Gilligan
• Andrew Gillihan, DPT
• Carol A Gillis, AA

• Physical Therapist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.