Jay M. Gillenwater, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101226171 Issued in VA

Practice address

1011 E Jefferson St
Charlottesville, VA 22902-5354

Phone

(434) 296-9161

Fax

(434) 977-6068

NPI assigned

Nov 7, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jay.gillenwater@paoc.eclinicaldirectplus.com

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.

• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1528137155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1878 KERNWOOD PL",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 E JEFFERSON ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025354",
            "telephone_number": "434-296-9161",
            "fax_number": "434-977-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLENWATER",
        "first_name": "JAY",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101226171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528137155",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Truwit Gilgannon, MD
• Kristen Gill, AG-ACNP
• Margo L K Gill, MD
• Stephanie Modena Gillan, NP
• Heidi H Gillenwater
• Jay Y. Gillenwater, M.D.
• Tracy Gillespie, BCBA, LBA
• Kristine Gillis, AG-ACNP
• Nathaniel T Gillispie, PT, DPT
• Sarah Gillispie, DPT

• Pediatrics Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.