Beth L Gillis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25269-020 Issued in WI

Practice address

W3275 Wolf River Dr
Keshena, WI 54135-9202

Phone

(715) 799-3361

Fax

(715) 799-1326

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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 WI

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

Family Practice

Education

Medical College of Wisconsin, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Menominee Indian Tribe of WisconsinGroup PAC ID 2668459264, 24 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Menominee Indian Tribe of Wisconsin

  • Family Medicine Physician
  • Keshena, WI
  • NPI 1568404721
  Medicare reassignment Care Compare group NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1144991340
  Medicare reassignment NPD
• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • General Acute Care Hospital
  • Rhinelander, WI
  • NPI 1356391247
  NPD
• Radiology Associates of Appleton, S.C.

  • Diagnostic Radiology Physician
  • Appleton, WI
  • NPI 1841229093
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1245262351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "541350970",
            "telephone_number": "715-799-5490",
            "fax_number": "715-799-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3275 WOLF RIVER DR",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "541359202",
            "telephone_number": "715-799-3361",
            "fax_number": "715-799-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "BETH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "25269-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30556300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiersten Ann Fischer, APSW
• Ryan Forbey, LPC
• Carol J Foss, PH D
• Ronald D Freeman, D.M.D.
• Mark P Fuller, LCSW, SAC, ICS,
• Joseph E Guenther, M.D.
• Holly Ann Gumieny
• Sarah Harkey, APNP
• Diane Marie Hietpas, MA, SAC
• James Garrett Hines, D.M.D

• Family Medicine Physician in Keshena, WI
• Providers in Keshena, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.