Nicole L Gillard, OTR/L, ATP

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

670 Branson Landing Blvd
Branson, MO 65616-2074

Phone

(417) 332-2990

Fax

(417) 332-1799

NPI assigned

Sep 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Aegis Group Practice LLC

  • Occupational Therapist
  • Kirkwood, MO
  • NPI 1558819508
  Medicare reassignment Care Compare group NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Springfield, MO
  • NPI 1902516727

  Occupational Therapist

  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1932072030

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1043794522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 S FREMONT AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 BRANSON LANDING BLVD",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162074",
            "telephone_number": "417-332-2990",
            "fax_number": "417-332-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLARD",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "OTR/L, ATP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gateway Hospice Care, LLC
• Gentle Dental Centers of the Ozrks, LLC Brett D Wyman Sole Member
• Geriatric Specialists, LLC
• Alix Renee Gilbert, PA-C
• Derrick Gilbert, CRADC
• Roy Jack Gillispie, MD
• Jerry Samuel Givens, M.D.
• Teresa K Givens, CRNA
• Good Shepherd Family Clinic Inc
• Max H Goodwin, M.D.

• Occupational Therapist in Branson, MO
• Providers in Branson, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.