Individual provider Active NPI

Jamie Gilles, PHARMD

  • Pharmacist
  • Spring Lake, NC
National Provider Identifier
1376820761
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21676 Issued in NC
Practice address
512 Villag Lake Court Apt # 201
Spring Lake, NC 28390
Phone
(910) 433-4681
Fax
(910) 433-2892
NPI assigned
Nov 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21676 NC Primary

Addresses

Primary practice location

512 Villag Lake Court Apt # 201
Spring Lake, NC 28390

Mailing address

512 Village Lake CT Apt 201
Spring Lake, NC 28390-3461
Phone (910) 433-4681

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
21676NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1376820761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 VILLAGE LAKE CT APT 201",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283903461",
            "telephone_number": "910-433-4681",
            "fax_number": "910-433-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 VILLAG LAKE COURT APT # 201",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "28390",
            "telephone_number": "910-433-4681",
            "fax_number": "910-433-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLES",
        "first_name": "JAMIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "21676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.

Verify at the official NPI Registry.