Individual provider Active NPI

Deborah Delan Gilliam, PT

  • Physical Therapist
  • Panama City, FL
National Provider Identifier
1508244674
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4882 Issued in FL
Practice address
200 Doctors Dr
Panama City, FL 32405-4559
Phone
(850) 784-7724
Fax
(850) 784-4711
NPI assigned
May 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4882 FL Primary

Addresses

Primary practice location

200 Doctors Dr
Panama City, FL 32405-4559

Mailing address

200 Doctors Dr
Panama City, FL 32405-4559
Phone (850) 784-7724

Other names 1

  • Delan T Gilliam Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060118000735 FL Practitioner - Physical Therapist in Private Practice 5597789487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
52.44 of 100Reported as group
Quality
0
Improvement activities
40
Cost
74.78

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4882FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Oct 1, 2024 Accepting new patients
Orthopedic & Sports Physical Therapy Center LLC Current Accepting new patients
North Florida Surgeons, PA CurrentSince Oct 1, 2024 Accepting new patients
Orthopedic & Sports Physical Therapy Center LLC CurrentSince Jul 21, 2019 Accepting new patients
South Palm Physical Therapy Services Inc Physical Therapist Past Accepting new patients

Locations

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

1950 Bluewater Blvd
Ste 101
Niceville, FL 32578
Phone (850) 897-3334

1950 Bluewater Blvd
Ste 100
Niceville, FL 32578
Phone (850) 897-8081

1040 Gulf Breeze Pkwy
Ste 200
Pensacola Beach, FL 32561
Phone (850) 916-8711

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1508244674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054559",
            "telephone_number": "850-784-7724",
            "fax_number": "850-784-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054559",
            "telephone_number": "850-784-7724",
            "fax_number": "850-784-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "DEBORAH",
        "middle_name": "DELAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "4882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELAN",
            "last_name": "GILLIAM",
            "middle_name": "T",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.