NPIMap

Individual provider Active NPI

Caleb Gillham, MD

  • Family Medicine Physician
  • Omak, WA
National Provider Identifier
1255860086
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61014528 Issued in WA
Practice address
916 Koala Dr
Omak, WA 98841-9759
Phone
(509) 663-8711
NPI assigned
Jun 6, 2017
Last updated
Jul 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 94-09177 KS
Family Medicine Physician 207Q00000X MD61014528 WA Primary

Addresses

Primary practice location

916 Koala Dr
Omak, WA 98841-9759

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cgillham78794@edirect.chehr.org
FHIR URL https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200612000429 WA Practitioner - Family Practice 4688945918 Reassigns benefits to 1 organization
I20250924004783 OR Practitioner - Family Practice 4688945918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hermiston Medical Center P CGroup PAC ID 9133028798, 10 clinicians
Central Washington Health Services AssociationGroup PAC ID 4880504596, shared by 25 NPIs, 708 clinicians

Practice addresses (Care Compare)

10 NE 5TH Ave
Milton Freewater, OR 97862-1702
Phone (541) 567-6434

600 NW 11TH St
Suite E15
Hermiston, OR 97838-8602
Phone (541) 567-6434

916 Koala Dr
Omak, WA 98841-9759
Phone (509) 663-8711

933 Red Apple Rd
Wenatchee, WA 98801-3370
Phone (509) 663-8711

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
94-09177KSMDFamily Medicine Physician
MD61014528WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hermiston Medical Center P C CurrentSince Sep 1, 2025 Accepting new patients
Hermiston Medical Center P C Family Medicine CurrentSince Sep 1, 2025 Accepting new patients
Wenatchee Valley Hospital CurrentSince Jun 1, 2020 Accepting new patients
Wenatchee Valley Hospital Current Accepting new patients
Okanogan County Public Hospital District No. 3 Past Accepting new patients

Locations

600 NW 11th St
Ste E15
Hermiston, OR 97838
Phone (541) 567-6434

10 NE 5th Ave
Milton Frwtr, OR 97862
Phone (541) 567-6434

916 Koala Dr
Omak, WA 98841
Phone (509) 826-1800

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

Interoperability endpoints

  • Direct secure messaging: caleb.gillham.1@31984.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1255860086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 KOALA DR",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419759",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLHAM",
        "first_name": "CALEB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-06",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "94-09177",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61014528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgillham78794@edirect.chehr.org",
            "affiliation": "N",
            "address_1": "916 Koala Dr",
            "city": "Omak",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988419759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "820 N Chelan Ave",
            "city": "Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988012028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omak, WA

Sources for this page

Verify at the official NPI Registry.