Rebecca Ann Gillingham, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

402377 Issued in NY

Practice address

30 Crescent Ave
Saratoga Springs, NY 12866

Phone

(518) 584-3600

NPI assigned

May 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 27, 2023 through Apr 27, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1386134260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WAYNE CT",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128049107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CRESCENT AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "12866",
            "telephone_number": "518-584-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLINGHAM",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "583553",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Scarlett Georgia, PT
• Elyssa Gersen-Thurman, LMHC
• Prajesh Mani Ghimire, M.D.
• E. Brooke Gifford, PA
• Scott Gillet, LCSW
• Richard W Glaim
• Glenn Park DDS PLLC
• Robert I Goguen
• Daniel Gold, PA
• John M Gold, MD

• Psychiatric/Mental Health Nurse Practitioner in Saratoga Springs, NY
• Providers in Saratoga Springs, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.