NPIMap

Individual provider Active NPI

Gayla Janine Dillard, M.D.

  • Surgery Physician
  • Conyers, GA
National Provider Identifier
1649291659
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35241 Issued in GA
Practice address
1364 Wellbrook Cir NE
Conyers, GA 30012-3872
Phone
(770) 761-7171
Fax
(770) 761-7179
NPI assigned
Jul 22, 2006
Last updated
Nov 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 035241 GA
Surgery Physician 208600000X 35241 GA Primary

Addresses

Primary practice location

1364 Wellbrook Cir NE
Conyers, GA 30012-3872

Mailing address

1364 Wellbrook Cir NE
Conyers, GA 30012-3872
Phone (770) 761-7171

Other identifiers 1

IdentifierTypeStateIssuer
00489255CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051208000069 GA Practitioner - General Surgery 4183644149 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Meharry Medical College School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1364 Wellbrook Cir NE
Conyers, GA 30012-3872
Phone (770) 761-7171

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)13
Mastectomy17
Melanoma (skin cancer) excision1-10
Removal of tissue70
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
333COMDSpinal Cord Injury Medicine Physician
35241GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gayla Dillard MD PC Surgery CurrentSince Nov 1, 2005 Accepting new patients
Healogics Specialty Physicians of Georgia, LLC CurrentSince Aug 27, 2018 Accepting new patients
Healogics Specialty Physicians of Georgia, LLC CurrentSince Aug 27, 2018 Accepting new patients
Piedmont Specialty Hospital Billing LLC CurrentSince Aug 26, 2018 Accepting new patients
Piedmont Providers LLC PastSince Dec 10, 2018 Accepting new patients

Locations

1364 Wellbrook Cir NE
Conyers, GA 30012
Phone (770) 285-3533

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

705 Breedlove Dr
Ste 300
Monroe, GA 30655
Phone (678) 635-7221

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1649291659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 WELLBROOK CIR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123872",
            "telephone_number": "770-761-7171",
            "fax_number": "770-761-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 WELLBROOK CIR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123872",
            "telephone_number": "770-761-7171",
            "fax_number": "770-761-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "GAYLA",
        "middle_name": "JANINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "035241",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "35241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00489255C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.