NPIMap

Individual provider Active NPI

Joseph Eisele Gillham, M.D.

  • Family Medicine Physician
  • Rockingham, NC
National Provider Identifier
1053624296
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2014-02114 Issued in NC
Practice address
921 S Long Dr Ste 101
Rockingham, NC 28379-4874
Phone
(910) 417-3850
NPI assigned
Jul 16, 2010
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0116022508 VA
Family Medicine Physician 207Q00000X DR.0071618 CO
Family Medicine Physician 207Q00000X 2014-02114 NC Primary

Addresses

Primary practice location

921 S Long Dr Ste 101
Rockingham, NC 28379-4874

Mailing address

PO Box 17990
Belfast, ME 04915
Phone (910) 417-3850

Other practice location 1

5818 N Nevada Ave Ste 200
Colorado Springs, CO 80918-3505
Phone (719) 599-0444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170523001428 NC Practitioner - HospitalistPractitioner - Family Practice 7214204221 Reassigns benefits to 6 organizations
I20231121000076 CO Practitioner - Family Practice 7214204221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Select Physical Therapy of Colorado Springs LPGroup PAC ID 3971498197, shared by 2 NPIs, 84 clinicians

Practice addresses (Care Compare)

5818 N Nevada Ave
Suite 200
Colorado Springs, CO 80918-3505
Phone (719) 364-2554

5825 Delmonico Dr
Colorado Springs, CO 80919-2243
Phone (719) 257-4240

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014-02114NCMDFamily Medicine Physician
0116022508VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-8, LLC CurrentSince Mar 19, 2020 Accepting new patients
MCPC-8, LLC Family Medicine CurrentSince Mar 19, 2020 Accepting new patients
MCPC-16, LLC Family Medicine CurrentSince Mar 28, 2023 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 8, 2024 Accepting new patients
Firsthealth of the Carolinas, Inc Dba Firsthealth Weight Management Clinic CurrentSince Mar 28, 2023 Accepting new patients
FHPG, LLC Family Medicine Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 8, 2024 Accepting new patients
MCPC-17, LLC CurrentSince Mar 28, 2023 Accepting new patients
MCPC-17, LLC Family Medicine CurrentSince Mar 28, 2023 Accepting new patients
Firsthealth of the Carolinas, Inc. Family Medicine CurrentSince Mar 28, 2023 Accepting new patients
FHPG, LLC Family Medicine CurrentSince Jun 1, 2017 Accepting new patients
MCPC-8, LLC Family Medicine Current Accepting new patients
FHPG, LLC Family Medicine CurrentSince Jun 1, 2017 Accepting new patients
MCPC-2, LLC CurrentSince Mar 28, 2023 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

1021 W Hamlet Ave
Hamlet, NC 28345
Phone (910) 417-4100

1021 W Hamlet Ave
Ste 5
Hamlet, NC 28345
Phone (910) 205-0400

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

293 Olmsted Blvd
Ste 1
Pinehurst, NC 28374
Phone (910) 255-0033

46 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-6782

6322 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6700

6408 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6000

921 S Long Dr
Ste 101
Rockingham, NC 28379
Phone (910) 417-3850

925 S Long Dr
Rockingham, NC 28379
Phone (910) 417-3000

520 Allen St
Troy, NC 27371
Phone (910) 571-5000

522 Allen St
Ste 101
Troy, NC 27371
Phone (910) 571-5510

7473 NC 22 Hwy
Whispering Pines, NC 28327
Phone (910) 215-5100

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1053624296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17990",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "04915",
            "telephone_number": "910-417-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 S LONG DR STE 101",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283794874",
            "telephone_number": "910-417-3850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5818 N Nevada Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809183505",
            "country_code": "US",
            "telephone_number": "719-599-0444",
            "fax_number": "719-365-7150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLHAM",
        "first_name": "JOSEPH",
        "middle_name": "EISELE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-16",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116022508",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0071618",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2014-02114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockingham, NC

Sources for this page

Verify at the official NPI Registry.