NPIMap

Individual provider Active NPI

William John Gill, PA

  • Medical Physician Assistant
  • Wauchula, FL
National Provider Identifier
1427164334
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2155 Issued in FL
Practice address
515 Carlton St
Pioneer Medical Center
Wauchula, FL 33873-3407
Phone
(863) 773-6606
Fax
(863) 773-9542
NPI assigned
Aug 22, 2006
Last updated
Aug 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA2155 FL Primary

Addresses

Primary practice location

515 Carlton St
Pioneer Medical Center
Wauchula, FL 33873-3407

Mailing address

515 Carlton St
Wauchula, FL 33873-3407
Phone (863) 773-6606

Other identifiers 1

IdentifierTypeStateIssuer
290071800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100226000713 FL Practitioner - Physician Assistant 0042355299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

515 Carlton St
Wauchula, FL 33873-3407
Phone (863) 773-6606

533 Carlton St
Wauchula, FL 33873-3407
Phone (863) 773-3101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System-Sunbelt Inc CurrentSince Dec 1, 2010 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Dec 1, 2010 Accepting new patients
Family Medical Group PA Past Accepting new patients
Wauchula Hma Physician Management, LLC Past Accepting new patients
Adventist Health System-Sunbelt Inc Medical Past Accepting new patients

Locations

515 Carlton St
Wauchula, FL 33873
Phone (863) 773-6606

522 Carlton St
Wauchula, FL 33873
Phone (863) 773-0975

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1427164334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 CARLTON ST",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338733407",
            "telephone_number": "863-773-6606",
            "fax_number": "863-773-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 CARLTON ST",
            "address_2": "PIONEER MEDICAL CENTER",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338733407",
            "telephone_number": "863-773-6606",
            "fax_number": "863-773-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA2155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290071800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauchula, FL

Sources for this page

Verify at the official NPI Registry.