Active NPI
Michelle Leeann Gillham, BA, BHRS, CM
- Case Manager/Care Coordinator
- Boley, OK
National Provider Identifier
1285704643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- #9860
- Practice address
- RR 1, Box 35D
Boley, OK 74829 - Phone
- (918) 667-3367
- Fax
- (918) 667-3387
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | #9860 | OK | Primary |
Addresses
Primary practice location
RR 1, Box 35D
Boley, OK 74829
Mailing address
RT. 1, Box 117-1
Prague, OK 74864
Phone (405) 567-1297
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)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| #9860 | OK | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1285704643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RT. 1, BOX 117-1",
"city": "PRAGUE",
"state": "OK",
"postal_code": "74864",
"telephone_number": "405-567-1297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR 1, BOX 35D",
"city": "BOLEY",
"state": "OK",
"postal_code": "74829",
"telephone_number": "918-667-3367",
"fax_number": "918-667-3387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLHAM",
"first_name": "MICHELLE",
"middle_name": "LEEANN",
"credential": "BA, BHRS, CM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OK",
"license": "#9860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boley, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.