Active NPI
Gloria Gillyard
- Occupational Therapy Assistant
- Brooklyn Park, MD
National Provider Identifier
1609112770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- A00805
- Practice address
- 5106 Kramme Ave
Brooklyn Park, MD 21225-3019 - Phone
- (443) 418-8044
- NPI assigned
- Dec 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | A00805 | MD | Primary |
Addresses
Primary practice location
5106 Kramme Ave
Brooklyn Park, MD 21225-3019
Mailing address
5106 Kramme Ave
Brooklyn Park, MD 21225-3019
Phone (443) 418-8044
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 |
|---|---|---|---|
| A00805 | MD | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425945600000",
"number": "1609112770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5106 KRAMME AVE",
"city": "BROOKLYN PARK",
"state": "MD",
"postal_code": "212253019",
"telephone_number": "443-418-8044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5106 KRAMME AVE",
"city": "BROOKLYN PARK",
"state": "MD",
"postal_code": "212253019",
"telephone_number": "443-418-8044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLYARD",
"first_name": "GLORIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-18",
"last_updated": "2015-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MD",
"license": "A00805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.