NPIMap

Organization Active NPI

Gill Family Medicine, P.C.

  • Family Medicine Physician
  • Decatur, AL
National Provider Identifier
1467539775
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.12215 Issued in AL
Legal business name
GILL FAMILY MEDICINE, P.C.
Practice address
2422 Danville Rd SW Ste E
Decatur, AL 35603-4221
Phone
(256) 355-9040
Fax
(256) 355-9048
NPI assigned
Nov 1, 2006
Organization subpart
Yes
Parent organization
GILL FAMILY MEDICINE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Elaine Ladd Gill
Title
Cfo
Phone
(256) 355-9040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD.12215 AL Primary

Addresses

Primary practice location

2422 Danville Rd SW Ste E
Decatur, AL 35603-4221

Mailing address

PO Box 5750
Decatur, AL 35601-0750
Phone (256) 355-9040

Other identifiers 1

IdentifierTypeStateIssuer
529402090MedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alexander.mcqueen@gillfam.direct.medconnect-inc.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051128000787 AL Part B Supplier - Clinic/Group Practice 4587684188 Receives reassigned benefits from 8 practitioners
Practice locations: Decatur, AL

National Provider Directory

National Provider Directory
Part of
Gill Family Medicine PC

Practitioners & affiliated clinicians

Practitioners 8

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1467539775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5750",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356010750",
            "telephone_number": "256-355-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 DANVILLE RD SW STE E",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356034221",
            "telephone_number": "256-355-9040",
            "fax_number": "256-355-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILL FAMILY MEDICINE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GILL FAMILY MEDICINE, P.C.",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "LADD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "256-355-9040"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.12215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529402090",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alexander.mcqueen@gillfam.direct.medconnect-inc.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2422 Danville Rd SW",
            "address_2": "Suite E",
            "city": "Decatur",
            "state": "AL",
            "country_code": "US",
            "postal_code": "356034220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.