Owen Gillam

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT41539 Issued in FL

Practice address

3061 State Route 28
Herkimer, NY 13350-1041

Phone

(315) 717-0020

NPI assigned

Aug 24, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Florida Luna Care Physical Therapy LLC

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1114542032
  Medicare reassignment NPD

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

{
    "created_epoch": "1566604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1508413469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 STATE ROUTE 28",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133501041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3061 STATE ROUTE 28",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133501041",
            "telephone_number": "315-717-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLAM",
        "first_name": "OWEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-24",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT41539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Jose Garcia de Paredes, D.D.S.
• Jaime J Garcia de Paredes, D.D.S.
• Priscilla Helen Garlock, MD
• Stephanie Lynn Gee, LCSW-R
• Nathalie J. Gilbert
• Louis R Gimelli, PTA
• Melissa Ann Glova, RN, BSN
• Judith E Golden, OD
• Michelle L Gorski
• Sylvia Grande, SLP

• Physical Therapist in Herkimer, NY
• Providers in Herkimer, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.