Petula Monique Gillingham, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6097 Issued in AZ

Practice address

3130 E Baseline Rd Ste 107
Mesa, AZ 85204-7290

Phone

(480) 345-1980

Fax

(480) 926-1721

NPI assigned

Mar 5, 2008

Last updated

Feb 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

ChiropracticAlso: Physical Medicine and Rehabilitation

Education

Lincoln Chiropractic College, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Afc Physical Medicine of Mesa, PLLCGroup PAC ID 8123280716, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Afc Physical Medicine of Mesa, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
  • NPI 1659645679
  Medicare reassignment Care Compare group NPD
• Morris Chiropractic Inc

  • Chiropractor
  • Mesa, AZ
  • NPI 1306804539
  NPD (past)

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1124298211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 S ALMA SCHOOL RD STE 354",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103028",
            "telephone_number": "480-726-2287",
            "fax_number": "888-316-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 E BASELINE RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047290",
            "telephone_number": "480-345-1980",
            "fax_number": "480-926-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLINGHAM",
        "first_name": "PETULA",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "6097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "P01122517",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John William Gillan, DDS MS
• Suntchyl Gilles
• Shelby Gillespie, DC
• Jolana Jayne Gillette, BHT
• James Louis Gillilland, DO
• Yelena Gillman, FNP
• Kimberly Ann Gilmer, PA-C
• Alecia Danielle Gilpin
• Michelle Gilreath, PMHNP-BC
• Linda Gin, PA-C

• Chiropractor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.