Mary Alyssa Gillis

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

902060 Issued in MS

Practice address

56 Dutch LN
Columbus, MS 39702-5500

Phone

(662) 329-3808

Fax

(662) 329-3873

NPI assigned

Jun 2, 2016

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 MS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dutch Medical Clinics, IncGroup PAC ID 9234376088, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Columbus, MS, CCN 257110
• Mississippi Homecare of Eupora Home health agency, Eupora, MS, CCN 257122
• BMH-Golden Triangle Hospital, Columbus, MS, CCN 250100

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: mary.gillis.5@17762.direct.athenahealth.com

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.

• Dutch Medical Clinics, Inc

  • Multi-Specialty Clinic/Center
  • Columbus, MS
  • NPI 1215276175
  Medicare reassignment Care Compare group
• Dutch Medical Clinics, Inc.

  • Family Medicine Physician
  • Columbus, MS
  • NPI 1639681976
  NPD (past)

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

• Able Home Health, Inc.

  • Home Health Agency
  • Eupora, MS
  • NPI 1659483196
  Care Compare affiliation
• Baptist Memorial Hospital - Golden Triangle Inc.

  • General Acute Care Hospital
  • Columbus, MS
  • NPI 1609830173
  Care Compare affiliation
• Home Health Care Affiliates of Mississippi, Inc.

  • Home Health Agency
  • Columbus, MS
  • NPI 1770589822
  Care Compare affiliation

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1285082925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 DUTCH LN",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397025500",
            "telephone_number": "662-329-3808",
            "fax_number": "662-329-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 DUTCH LN",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397025500",
            "telephone_number": "662-329-3808",
            "fax_number": "662-329-3873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 11th Ave S",
            "address_2": "Suite 410",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352053423",
            "country_code": "US",
            "telephone_number": "205-939-4939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3654B New Hope Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "MS",
            "postal_code": "397028521",
            "country_code": "US",
            "telephone_number": "662-329-1488",
            "fax_number": "662-329-1440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "MARY",
        "middle_name": "ALYSSA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-02",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07121209",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Gibson, M.S., CCC-SLP
• Gilden Magnolia Life Care LLC
• Melissa Gillespie Anderson, RPH
• William Meek Gillespie III, M.D.
• Amanda Gilliland
• Tawana Gipson, PMHNP-BC
• Global Pharmaceutical Corporation
• Glory Home Care Services
• Lillian Ainsworth Glusenkamp, R.D.
• GN Hearing Care Corp

• Family Nurse Practitioner in Columbus, MS
• Providers in Columbus, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.