Timothy Gillespie

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C7558 Issued in MS

Practice address

5500 Highway 363
Mantachie, MS 38855-7197

Phone

(662) 282-4335

NPI assigned

Jul 30, 2015

Last updated

Jul 30, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mantachie Rural Health Care, IncGroup PAC ID 2567372121, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIBHBA
• Direct secure messaging: timothy.gillespie@mrhc.eclinicaldirectplus.com

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.

• Mantachie Rural Health Care, Inc

  dba Mantachie Clinic

  • Family Medicine Physician
  • Mantachie, MS
  • NPI 1033169545
  Medicare reassignment Care Compare group NPD
• Mantachie Rural Health Care, Inc

  dba Dorsey Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Fulton, MS
  • NPI 1508652330
  NPD
• Mantachie Rural Health Care, Inc

  dba Mantachie Rural Health Care, Inc. Dorsey School

  • Federally Qualified Health Center (FQHC)
  • Fulton, MS
  • NPI 1447031943
  NPD (past)

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1215312335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "388550040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 HIGHWAY 363",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "388557197",
            "telephone_number": "662-282-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Extra Mile Recovery, LLC
• Kerri Fleming, OTR
• Amy Lynn Floyd, FNP-C
• Joy Y Franks, CFNP
• Resa Frederick, M.ED, NCC, LPC
• Hometown Care of Mantachie LLC
• Bonnie Renee' Jones, MSN, APRN, FNP-C
• Katherine E Jones, FNP-BC
• Ginger Little
• James Brandon Loden

• Clinical Social Worker in Mantachie, MS
• Providers in Mantachie, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.