Active NPI
Theresa Lynn Gilliam, MS, OTRL, CLT-LANA
- Occupational Therapist
- Chapel Hill, NC
National Provider Identifier
1235345604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5631
- Practice address
- 187 Birnamwood Dr
Chapel Hill, NC 27516-9610 - Phone
- (919) 967-8583
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5631 | NC | Primary |
Addresses
Primary practice location
187 Birnamwood Dr
Chapel Hill, NC 27516-9610
Mailing address
187 Birnamwood Dr
Chapel Hill, NC 27516-9610
Phone (919) 967-8583
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 186565 | Other | NC | MEDCOST |
| 1407M | Other | NC | BCBS NC |
| 0443M | Other | NC | BCBSNC DME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5631 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lymflo Therapies, Inc. | Past | Accepting new patients | |
| Wellness One, Inc | Occupational Therapist | Past | Accepting new patients |
| Lymflo Therapies, Inc. | Past | Accepting new patients |
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.
-
- Durable Medical Equipment & Medical Supplies
- Chapel Hill, NC
- NPI 1366438467
-
- Specialist
- Chapel Hill, NC
- NPI 1568457646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237939200000",
"number": "1235345604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "187 BIRNAMWOOD DR",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275169610",
"telephone_number": "919-967-8583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "187 BIRNAMWOOD DR",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275169610",
"telephone_number": "919-967-8583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "THERESA",
"middle_name": "LYNN",
"credential": "MS, OTRL, CLT-LANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2009-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "5631",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "186565",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC",
"identifier": "1407M",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC DME",
"identifier": "0443M",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chapel Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.