Individual provider Active NPI

Ashley Carpenter Gilliland, ANP

  • Adult Health Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1104253699
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R895264 Issued in MS
Practice address
961 S Gloster St
Tupelo, MS 38801-6343
Phone
(662) 844-9166
Fax
(662) 844-0170
NPI assigned
Sep 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R895264 MS Primary

Addresses

Primary practice location

961 S Gloster St
Tupelo, MS 38801-6343

Mailing address

961 S Gloster St
Tupelo, MS 38801-6343
Phone (662) 844-9166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140103001084 MS Practitioner - Nurse Practitioner 2466680053 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medcial Center, Inc. CurrentSince Aug 26, 2015 Accepting new patients
Clay County Medical Corporation CurrentSince Jun 5, 2018 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Clay County Medical Corporation Current Accepting new patients
Clay County Medical Corporation CurrentSince Jun 5, 2018 Accepting new patients
North Mississippi Medical Center Inc. CurrentSince Aug 26, 2015 Accepting new patients
Clay County Medical Corporation Current Accepting new patients

Locations

1205 Highway 182 W
Starkville, MS 39759
Phone (662) 320-8545

4381 S Eason Blvd
Ste 202
Tupelo, MS 38801
Phone (662) 377-6470

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

961 S Gloster St
Tupelo, MS 38801
Phone (601) 844-9166

961 S Gloster St
Ste A
Tupelo, MS 38801
Phone (662) 377-2964

150 Medical Center Dr
West Point, MS 39773
Phone (601) 494-2321

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1104253699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016343",
            "telephone_number": "662-844-9166",
            "fax_number": "662-844-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016343",
            "telephone_number": "662-844-9166",
            "fax_number": "662-844-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "ASHLEY",
        "middle_name": "CARPENTER",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R895264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.