Organization Active NPI

Gillie Aesthetics and Dermatology, PLC

  • Dermatology Physician
  • Murfreesboro, TN
National Provider Identifier
1306537808
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
GILLIE AESTHETICS AND DERMATOLOGY, PLC
Practice address
1602 W Northfield Blvd Ste 300
Murfreesboro, TN 37129-1744
Phone
(615) 801-7674
Fax
(615) 281-3356
NPI assigned
May 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Authorized official

Name
Mrs. Gillian H Choate, APRNNPI 1124354162
Title
Owner and Nurse Practitioner
Phone
(615) 218-2434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1602 W Northfield Blvd Ste 300
Murfreesboro, TN 37129-1744

Mailing address

1602 W Northfield Blvd Ste 300
Murfreesboro, TN 37129-1744
Phone (615) 801-7674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231127000467 TN Part B Supplier - Clinic/Group Practice 8325496748 Receives reassigned benefits from 3 practitioners
Practice locations: Murfreesboro, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2281802Gillie Aesthetics and Dermatology, PLC1602 W Northfield Blvd Ste 300, Murfreesboro, TN 37129Certificate of waiverMay 11, 2027

National Provider Directory

National Provider Directory

Locations

1602 W Northfield Blvd
Ste 300
Murfreesboro, TN 37129
Phone (615) 801-7674

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1306537808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 W NORTHFIELD BLVD STE 300",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291744",
            "telephone_number": "615-801-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W NORTHFIELD BLVD STE 300",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291744",
            "telephone_number": "615-801-7674",
            "fax_number": "615-281-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILLIE AESTHETICS AND DERMATOLOGY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "CHOATE",
        "authorized_official_first_name": "GILLIAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER AND NURSE PRACTITIONER",
        "authorized_official_telephone_number": "615-218-2434",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.