Active NPI
Joshua Matthew Gilliam, RNFA
- Registered Nurse First Assistant
- Portland, OR
National Provider Identifier
1538690516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse First Assistant
- License
- 200540962RN
- Practice address
- 9205 SW Barnes Rd
Portland, OR 97225-6603 - Phone
- (503) 216-1234
- NPI assigned
- Mar 22, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | 200540962RN | OR | Primary |
Addresses
Primary practice location
9205 SW Barnes Rd
Portland, OR 97225-6603
Mailing address
9660 SW Saddle Dr
Beaverton, OR 97008-6744
Phone (503) 338-0515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200540962RN | OR | MD | Registered Nurse First Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490140800000",
"number": "1538690516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9660 SW SADDLE DR",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970086744",
"telephone_number": "503-338-0515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9205 SW BARNES RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256603",
"telephone_number": "503-216-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "JOSHUA",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "RNFA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-22",
"last_updated": "2017-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "163WR0006X",
"taxonomy_group": "",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": "OR",
"license": "200540962RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.