Active NPI
Jennifer Michelle Gilliam, SLP
- Speech-Language Pathologist
- McKinney, TX
National Provider Identifier
1336178771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 100587
- Practice address
- 5521 Fairfax CT
McKinney, TX 75070-9329 - Phone
- (214) 679-3505
- NPI assigned
- Jun 30, 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 100587 | TX | Primary |
Addresses
Primary practice location
5521 Fairfax CT
McKinney, TX 75070-9329
Mailing address
5521 Fairfax CT
McKinney, TX 75070-9329
Phone (214) 679-3505
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1552135-02 | Medicaid | TX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100587 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305590400000",
"number": "1336178771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5521 FAIRFAX CT",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750709329",
"telephone_number": "214-679-3505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5521 FAIRFAX CT",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750709329",
"telephone_number": "214-679-3505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "JENNIFER",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2011-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "100587",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1552135-02",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in McKinney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.