Organization Active NPI

Jona K Gill MD PC

  • Dermatology Physician
  • Chelsea, MI
National Provider Identifier
1457366197
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
JONA K GILL MD PC
Practice address
14650 E Old US Highway 12
Suite 308
Chelsea, MI 48118-1801
Phone
(734) 475-3221
Fax
(734) 475-6411
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Authorized official

Name
Jona K Gill, MDNPI 1184682510
Title
Owner
Phone
(734) 475-3221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

14650 E Old US Highway 12
Suite 308
Chelsea, MI 48118-1801

Mailing address

14650 E Old US Highway 12
Suite 308
Chelsea, MI 48118-1801
Phone (734) 475-3221

Other names 1

  • Chelsea Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050204000643 MI Part B Supplier - Clinic/Group Practice 4880645019 Receives reassigned benefits from 4 practitioners
Practice locations: Chelsea, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D1007218Jona K Gill, MD, PC14650 E Old US Hwy 12 Suite 308, Chelsea, MI 48118ComplianceApr 16, 2028

National Provider Directory

National Provider Directory

Locations

14650 E Old US Highway 12
Ste 308
Chelsea, MI 48118
Phone (734) 475-3221

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1457366197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14650 E OLD US HIGHWAY 12",
            "address_2": "SUITE 308",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181801",
            "telephone_number": "734-475-3221",
            "fax_number": "734-475-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 E OLD US HIGHWAY 12",
            "address_2": "SUITE 308",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181801",
            "telephone_number": "734-475-3221",
            "fax_number": "734-475-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONA K GILL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "JONA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-475-3221",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chelsea Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chelsea, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.