Kelli Gillman

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-132253 Issued in AL

Practice address

1083 E Relham Dr
Loxley, AL 36551-2406

Phone

(251) 964-4011

Fax

(251) 964-4012

NPI assigned

Mar 17, 2016

Last updated

Mar 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Franklin Primary Health Center, Inc.Group PAC ID 1658356308, 50 clinicians

Jeanne M Birkenhauer, M.D., P.C.Group PAC ID 9537220397, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baldwin Health Hospital, Foley, AL, CCN 010083

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgillman374729@direct.ochin.org

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.

• Franklin Primary Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
  • NPI 1679532303
  Medicare reassignment Care Compare group NPD
• Jeanne M Birkenhauer, M.D., P.C.

  • Family Medicine Physician
  • Gulf Shores, AL
  • NPI 1841375417
  Medicare reassignment Care Compare group NPD
• Franklin Primary Health Center, Inc

  dba Franklin Evergreen Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Evergreen, AL
  • NPI 1346733821
  NPD
• Franklin Primary Health Center, Inc.

  dba H E Savage Memorial Ctr

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
  • NPI 1104895952
  NPD (past)

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

• Foley Hospital Company LLC

  dba Baldwin Health

  • General Acute Care Hospital
  • Foley, AL
  • NPI 1053382655
  Care Compare affiliation

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1295196251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 DR MARTIN L KING JR AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366035341",
            "telephone_number": "251-432-4117",
            "fax_number": "251-436-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 E RELHAM DR",
            "city": "LOXLEY",
            "state": "AL",
            "postal_code": "365512406",
            "telephone_number": "251-964-4011",
            "fax_number": "251-964-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLMAN",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-132253",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-132253",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "AL",
            "license": "1-132253",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-132253",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-132253",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AL",
            "license": "1-132253",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1-132253",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Danielson
• Philip Michael Dembowski, D.C.
• Matthew Dorsett, FNP-C
• Franklin Primary Health Center, Inc
• Franklin Primary Health Center, Inc. (Loxley Family Medical Center)
• Melissa Goldman, CRNP
• Gulf Coast Pharmaceuticals LLC
• Laticia Hall, LICSW
• Crystal Smith Hanson
• Hemophilia Infusion Managers LLC

• Nurse Practitioner in Loxley, AL
• Providers in Loxley, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.