Individual provider Active NPI

Ronda Lyn Gillis

  • Registered Nurse
  • Susanville, CA
National Provider Identifier
1043152887
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95318406 Issued in CA
Practice address
2011 Main St
Susanville, CA 96130-4501
Phone
(530) 261-6739
NPI assigned
Apr 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95318406 CA Primary

Addresses

Primary practice location

2011 Main St
Susanville, CA 96130-4501

Mailing address

2011 Main St
Susanville, CA 96130-4501
Phone (530) 261-6739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95318406CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1043152887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 MAIN ST",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "961304501",
            "telephone_number": "530-261-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 MAIN ST",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "961304501",
            "telephone_number": "530-261-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "RONDA",
        "middle_name": "LYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95318406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Susanville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.