Individual provider Active NPI

Gillian D Ralls, PA-C

  • Medical Physician Assistant
  • New Haven, CT
National Provider Identifier
1063539328
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000234 Issued in CT
Practice address
55 Lock St
New Haven, CT 06511-3603
Phone
(203) 432-7978
Fax
(203) 432-7828
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000234 CT Primary

Addresses

Primary practice location

55 Lock St
New Haven, CT 06511-3603

Mailing address

PO Box 208237
55 Lock Street
New Haven, CT 06520
Phone (203) 432-0312

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000234CTMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1063539328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208237",
            "address_2": "55 LOCK STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06520",
            "telephone_number": "203-432-0312",
            "fax_number": "203-432-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LOCK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113603",
            "telephone_number": "203-432-7978",
            "fax_number": "203-432-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALLS",
        "first_name": "GILLIAN",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "000234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.