Gill Memorial ENT Clinic, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101031266 Issued in VA

Legal business name

GILL MEMORIAL ENT CLINIC, PC

Practice address

707 S Jefferson St FL 5
Roanoke, VA 24016-5100

Phone

(540) 344-2071

Fax

(540) 982-8490

NPI assigned

Jun 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark R Hanabury Jr., M.D.NPI 1134121338

Title

Owner

Phone

(540) 344-2071

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

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

• Mark R Hanabury Jr., M.D.

  • Otolaryngology Physician
  • Salem, VA
  • NPI 1134121338

  Specialist

  NPD (past) Authorized official

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1497957419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S JEFFERSON ST FL 5",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240165100",
            "telephone_number": "540-344-2071",
            "fax_number": "540-982-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S JEFFERSON ST FL 5",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240165100",
            "telephone_number": "540-344-2071",
            "fax_number": "540-982-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILL MEMORIAL ENT CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "HANABURY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-344-2071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101031266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4243474",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "143175",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "243144",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00143294",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gigi Transportation LLC
• Carol M Gilbert, M.D.
• Kierra Gilbert, LCSW
• Kristin Forehand Gilbert, LPSC
• Margaret Gilbert, CRNA
• Katherine Julie Gill, NP
• Jacob R Gillen, MD
• Amanda Lynn Gillespie-Twardy, M.D.
• Jayna Madeleine Gillespie, LPC
• Daphne Gilliam, BCABA

• Specialist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; 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.