Active NPI
David Gillenwater, M.D.
- Psychiatry Physician
- Canton, GA
National Provider Identifier
1285797639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 043052
- Practice address
- 191 Lamar Haley Pkwy
Canton, GA 30114-8019 - Phone
- (770) 704-1600
- Fax
- (770) 704-1610
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 043052 | GA | Primary |
Addresses
Primary practice location
191 Lamar Haley Pkwy
Canton, GA 30114-8019
Mailing address
1401 Burleyson Dr
Dalton, GA 30720-2522
Phone (706) 270-5002
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Rivers CSB | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Highland Rivers Whitfield Treatment Services
- Community/Behavioral Health Agency
- Dalton, GA
- NPI 1164585543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285797639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 BURLEYSON DR",
"city": "DALTON",
"state": "GA",
"postal_code": "307202522",
"telephone_number": "706-270-5002",
"fax_number": "706-270-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 LAMAR HALEY PKWY",
"city": "CANTON",
"state": "GA",
"postal_code": "301148019",
"telephone_number": "770-704-1600",
"fax_number": "770-704-1610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLENWATER",
"first_name": "DAVID",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "043052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.