Active NPI
Benny Elbert Gilliard III
- Athletic Trainer
- Homewood, AL
National Provider Identifier
1083138200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 800 Lakeshore Dr
Homewood, AL 35209-6715 - Phone
- (205) 726-2011
- NPI assigned
- Jul 30, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
800 Lakeshore Dr
Homewood, AL 35209-6715
Mailing address
3 Fairoaks CT
Greenville, SC 29615-4339
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501372800000",
"number": "1083138200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 FAIROAKS CT",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 LAKESHORE DR",
"city": "HOMEWOOD",
"state": "AL",
"postal_code": "352096715",
"telephone_number": "205-726-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIARD",
"first_name": "BENNY",
"middle_name": "ELBERT",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-30",
"last_updated": "2017-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homewood, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.