Individual provider Active NPI

Allison Gilley, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brookhaven, GA
National Provider Identifier
1124674999
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN217118 Issued in GA
Practice address
2801 Buford Hwy NE Ste 100
Brookhaven, GA 30329-2146
Phone
(678) 820-7830
NPI assigned
Aug 16, 2019
Last updated
Aug 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN217118 GA Primary

Addresses

Primary practice location

2801 Buford Hwy NE Ste 100
Brookhaven, GA 30329-2146

Mailing address

2515 Ashton Dr
Roswell, GA 30076-4236
Phone (404) 989-2753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191025001569 GA Practitioner - Nurse Practitioner 7810229713 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN217118GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Aug 21, 2019 Accepting new patients

Locations

2801 Buford Hwy NE
Ste 100
Brookhaven, GA 30329
Phone (678) 820-7830

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: allison.gilley@3781.securemail.prognocis.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1124674999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 ASHTON DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764236",
            "telephone_number": "404-989-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE STE 100",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292146",
            "telephone_number": "678-820-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEY",
        "first_name": "ALLISON",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN217118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.