Manya Gordon Gillies, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

101.0137162 Issued in VT

Practice address

130 Fisher Rd
Berlin, VT 05602-9516

Phone

(802) 371-4100

NPI assigned

Apr 29, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Manya Gordon Former name

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgordon403601@direct.uvmhealth.org

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.

• Central Vermont Medical Center Inc

  • Family Medicine Physician
  • Berlin, VT
  • NPI 1023028784
  Medicare reassignment NPD

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1548016793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 FISHER RD",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FISHER RD",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029516",
            "telephone_number": "802-371-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIES",
        "first_name": "MANYA",
        "middle_name": "GORDON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0137162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANYA",
            "last_name": "GORDON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andre Breidenthal Gilbert, M.D.
• Elizabeth Gilhooly
• Calvin Gilkey, M.D.
• Corinna Marie Gilkey, CNM
• Paul G Gill Jr., MD
• Sheila R Glaess, MD
• Lydia Gleason, DMD
• Jeffrey W Glosser, DDS
• Gary F Gordon, MA
• Helene A. Gosselin, BA

• Family Nurse Practitioner in Berlin, VT
• Providers in Berlin, VT by specialty
• Family Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.