Active NPI
Carli Gilliam-Wood, QIDP
- Specialist
- Allen Park, MI
National Provider Identifier
1316614233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 6375 Kolb Ave
Allen Park, MI 48101-2336 - Phone
- (313) 550-2291
- NPI assigned
- Aug 27, 2021
- Last updated
- Aug 27, 2021
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | NU | Primary |
Addresses
Primary practice location
6375 Kolb Ave
Allen Park, MI 48101-2336
Mailing address
6375 Kolb Ave
Allen Park, MI 48101-2336
Phone (313) 550-2291
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630022400000",
"number": "1316614233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6375 KOLB AVE",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "481012336",
"telephone_number": "313-550-2291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6375 KOLB AVE",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "481012336",
"telephone_number": "313-550-2291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM-WOOD",
"first_name": "CARLI",
"credential": "QIDP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-27",
"last_updated": "2021-08-27",
"certification_date": "2021-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.