Mary Tolliver Gilley, ANP-PP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

200450144NP ANP-PP Issued in OR

Practice address

1111 NE 99TH Avenue
Portland, OR 97220

Phone

(503) 963-2707

Fax

(503) 963-2802

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1447274337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322684",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NE 99TH AVENUE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97220",
            "telephone_number": "503-963-2707",
            "fax_number": "503-963-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEY",
        "first_name": "MARY",
        "middle_name": "TOLLIVER",
        "credential": "ANP-PP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "200450144NP ANP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269862",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9651860",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert J Gillespie, MD
• Shelley Gillespie, LCSW
• Darren L. Gillette, MD
• Jennifer Lyn Gillette
• Adrienne Rosanne Gilley
• Sandra Gillgam
• Sara Joy Gillham, ND
• Heather Gilliam
• Joshua Matthew Gilliam, RNFA
• Gillian Scott Counseling

• Adult Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.