Martha Jane Gilliam, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP7115 Issued in AZ

Practice address

5301 E Grant Rd
Tucson, AZ 85712-2805

Phone

(520) 324-3771

Fax

(520) 324-8091

NPI assigned

Dec 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Martha Jane Simpson Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: m.gilliam@camplcardio.directbygreenway.com

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

• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  Medicare reassignment Care Compare group NPD
• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Medicare reassignment NPD
• Tucson Medical Center

  dba Tucson Medical Center Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Tucson, AZ
  • NPI 1972876563
  NPD
• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427
  NPD (past)
• Tucson Medical Center

  dba Palo Verde Hospital

  • Psychiatric Hospital Unit
  • Tucson, AZ
  • NPI 1881683126
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Care Compare affiliation

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1578549333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31235",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511235",
            "telephone_number": "520-324-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-324-3771",
            "fax_number": "520-324-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "MARTHA",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN053744",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP0273",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN053744",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP7115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "574576",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "SIMPSON",
            "middle_name": "JANE",
            "credential": "ANP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patricia Lynn Gillett, LCSW
• Patricia A Gillette, PHD
• Wainani Jean Gillette
• Douglas Bailey Gilliam, DDS
• Edwin Gilliam, FP
• Nancy D Gilliam, L. AC.
• Kara Gilliland
• Meghan Gilliland, LCSW
• Marcella Anne Gillooly
• Jared Gilman, M.D.

• Adult Health Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.
• 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.