Individual provider Active NPI

Nicole Gillman, MD

  • Nephrology Physician
  • Atlanta, GA
National Provider Identifier
1609458199
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
16546 Issued in GA
Practice address
101 Woodruff Cir NE Ste 338
Atlanta, GA 30322-0257
Phone
(404) 727-2525
NPI assigned
Apr 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 16546 GA Primary

Addresses

Primary practice location

101 Woodruff Cir NE Ste 338
Atlanta, GA 30322-0257

Mailing address

100 Woodruff Cir NE Ste 327
Atlanta, GA 30322-0257
Phone (044) 727-5658

Other practice location 1

VCUHS Dept of Internal Medicine Residency, 980509
1250 E Marshall Street
Richmnd, VA 23298-0257
Phone (804) 828-8786

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16546GAMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1609458199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOODRUFF CIR NE STE 327",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303220257",
            "telephone_number": "044-727-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WOODRUFF CIR NE STE 338",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303220257",
            "telephone_number": "404-727-2525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "VCUHS Dept of Internal Medicine Residency, 980509",
            "address_2": "1250 E Marshall Street",
            "address_purpose": "LOCATION",
            "city": "Richmnd",
            "state": "VA",
            "postal_code": "232980257",
            "country_code": "US",
            "telephone_number": "804-828-8786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLMAN",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "16546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.