Stephen Darrell Gilliam, RN FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN075780 NP Issued in GA

Practice address

1905 Barnett Shoals Rd
Athens, GA 30605-3625

Phone

(706) 542-7053

NPI assigned

Sep 9, 2009

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1598098519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 WILLIAMSBURG LN",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306054528",
            "telephone_number": "706-542-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 BARNETT SHOALS RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053625",
            "telephone_number": "706-542-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "STEPHEN",
        "middle_name": "DARRELL",
        "name_prefix": "Dr.",
        "credential": "RN FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN075780 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tim John Gill, RN
• Syeda Fatima Raza Gillani
• Kristina Gilleland, LCSW
• Natalie Gillespie, PT
• William Gillespie, PT, ATC, CSCS
• Dylan Gillis, LPC
• Julee Ginn, PTA
• Brian A. Glaser, PH.D.
• Judy Glaser
• Alan D Glassman, M.D.

• Family Nurse Practitioner in Athens, GA
• Providers in Athens, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.