NPIMap

Individual provider Active NPI

Megan Dianne Gillem, D.O.

  • Family Medicine Physician
  • Flower Mound, TX
National Provider Identifier
1093005704
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P8476 Issued in TX
Practice address
4921 Long Prairie Rd
Suite 100
Flower Mound, TX 75028-2716
Phone
(972) 691-8700
Fax
(972) 691-8782
NPI assigned
Apr 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X P8476 TX Primary

Addresses

Primary practice location

4921 Long Prairie Rd
Suite 100
Flower Mound, TX 75028-2716

Mailing address

4921 Long Prairie Rd
Suite 100
Flower Mound, TX 75028-2716
Phone (972) 691-8700

Other identifiers 1

IdentifierTypeStateIssuer
340101001MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141111002355 TX Practitioner - Family Practice 1658593462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Clinic of North Texas, PLLCGroup PAC ID 9830084540, 212 clinicians

Practice addresses (Care Compare)

4921 Long Prairie Rd
Suite 100
Flower Mound, TX 75028-2742
Phone (972) 691-8700

Hospital & facility affiliations

  • DFW Home Health Home health agency, Denton, TX, CCN 679657
  • Medical City Lewisville Hospital, Lewisville, TX, CCN 450669
  • Medical City Denton Hospital, Denton, TX, CCN 450634
  • Texas Health Presbyterian Hospital Flower Mound Hospital, Flower Mound, TX, CCN 670068

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas, PLLC Family Medicine Current Accepting new patients
Medical Clinic of North Texas PLLC CurrentSince Sep 1, 2014 Accepting new patients
Medical Clinic of North Texas, PLLC Family Medicine CurrentSince Sep 1, 2014 Accepting new patients

Locations

808 N Nolan River Rd
Cleburne, TX 76033
Phone (817) 558-3937

4001 W 15th St
Ste 245
Plano, TX 75093
Phone (972) 596-5222

Interoperability endpoints

  • Direct secure messaging: megan.gillem@wellmed.eclinicaldirectplus.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1093005704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 LONG PRAIRIE RD",
            "address_2": "SUITE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282716",
            "telephone_number": "972-691-8700",
            "fax_number": "972-691-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 LONG PRAIRIE RD",
            "address_2": "SUITE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282716",
            "telephone_number": "972-691-8700",
            "fax_number": "972-691-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEM",
        "first_name": "MEGAN",
        "middle_name": "DIANNE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P8476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340101001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.