Active NPI
Jennifer Lynne Gillam, MPT
- Physical Therapist
- Festus, MO
National Provider Identifier
1437263159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2001023235
- Practice address
- 376 Festus Centre Dr
Festus, MO 63028-2462 - Phone
- (636) 937-2777
- NPI assigned
- Aug 18, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2001023235 | MO | Primary |
Addresses
Primary practice location
376 Festus Centre Dr
Festus, MO 63028-2462
Mailing address
376 Festus Centre Dr
Festus, MO 63028-2462
Phone (636) 937-2777
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Twin City Healt Services | Past | Accepting new patients | |
| Pain Management Partners LLC | 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.
-
- Rehabilitation Clinic/Center
- Chesterfield, MO
- NPI 1558557959
-
- Pain Clinic/Center
- Crystal City, MO
- NPI 1114944196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204848000000",
"number": "1437263159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "376 FESTUS CENTRE DR",
"city": "FESTUS",
"state": "MO",
"postal_code": "630282462",
"telephone_number": "636-937-2777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "376 FESTUS CENTRE DR",
"city": "FESTUS",
"state": "MO",
"postal_code": "630282462",
"telephone_number": "636-937-2777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLAM",
"first_name": "JENNIFER",
"middle_name": "LYNNE",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2008-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2001023235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Festus, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.