NPIMap

Individual provider Active NPI

Mary Leigh Gillespie, DMD

  • Dentist
  • Muscle Shoals, AL
National Provider Identifier
1366600249
Registry record updated May 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5185 Issued in AL
Practice address
1013 Avalon Ave
Muscle Shoals, AL 35661-2401
Phone
(256) 381-2100
Fax
(256) 381-4844
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5185 AL Primary

Addresses

Primary practice location

1013 Avalon Ave
Muscle Shoals, AL 35661-2401

Mailing address

1013 Avalon Ave
Muscle Shoals, AL 35661-2401
Phone (256) 381-2100

Other identifiers 1

IdentifierTypeStateIssuer
36209OtherALBCBS OF ALABAMA

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

LicenseStateTypeSpecialty
5185ALMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Ryerson & Associates Dental Dentist Past Accepting new patients
James a Ryerson DMD and Mary Leigh Gillespie DMD PC LLC Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1366600249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 AVALON AVE",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "356612401",
            "telephone_number": "256-381-2100",
            "fax_number": "256-381-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 AVALON AVE",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "356612401",
            "telephone_number": "256-381-2100",
            "fax_number": "256-381-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "MARY",
        "middle_name": "LEIGH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "5185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "36209",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muscle Shoals, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.