Active NPI
Rita Gillam, RN, MPH
- Registered Nurse
- Salem, OR
National Provider Identifier
1447561923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 201040887RN
- Practice address
- 3180 Center St NE
Salem, OR 97301-4532 - Phone
- (503) 588-5621
- Fax
- (503) 588-2920
- NPI assigned
- Jun 29, 2010
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201040887RN | OR | Primary |
Addresses
Primary practice location
3180 Center St NE
Salem, OR 97301-4532
Mailing address
2210 NW Everett St Apt 404
Portland, OR 97210-5594
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201040887RN | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1447561923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2210 NW EVERETT ST APT 404",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972105594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3180 CENTER ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973014532",
"telephone_number": "503-588-5621",
"fax_number": "503-588-2920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLAM",
"first_name": "RITA",
"credential": "RN, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-29",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "201040887RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.