Individual provider Active NPI

Kendall Gilligan, MD

  • Emergency Medicine Physician
  • Cherokee, NC
National Provider Identifier
1265516579
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
23928 Issued in NC
Practice address
1 Hospital Rd
Caller Box C-268
Cherokee, NC 28719
Phone
(828) 497-9163
Fax
(828) 497-1723
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 23928 NC Primary

Addresses

Primary practice location

1 Hospital Rd
Caller Box C-268
Cherokee, NC 28719

Mailing address

1 Hospital Rd
Caller Box C-268
Cherokee, NC 28719
Phone (828) 497-9163

Other identifiers 2

IdentifierTypeStateIssuer
35539OtherNCBCBSNC
1265516579MedicaidNC

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9187NCMDDentist
23928NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients
Highland Emergency Physicians, PLLC Emergency Medicine PastSince Mar 1, 2007 Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1265516579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL RD",
            "address_2": "CALLER BOX C-268",
            "city": "CHEROKEE",
            "state": "NC",
            "postal_code": "28719",
            "telephone_number": "828-497-9163",
            "fax_number": "828-497-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL RD",
            "address_2": "CALLER BOX C-268",
            "city": "CHEROKEE",
            "state": "NC",
            "postal_code": "28719",
            "telephone_number": "828-497-9163",
            "fax_number": "828-497-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIGAN",
        "first_name": "KENDALL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "23928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "35539",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265516579",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.