Active NPI
Josh Gilliam, PA-C
- Physician Assistant
- Tampa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9104634
- Practice address
- 14547 Bruce B Downs Blvd
Tampa, FL 33613-2709 - Phone
- (813) 979-0440
- Fax
- (813) 355-5054
- NPI assigned
- Jul 17, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9104634 | FL | Primary |
Addresses
Primary practice location
14547 Bruce B Downs Blvd
Tampa, FL 33613-2709
Mailing address
38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (813) 528-4975
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000340900 | Medicaid | FL | |
| P00982255 | Other | FL | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Select Physical Therapy Holdings IncSports and Orthopedic Rehabilitation Services Inc
Practice addresses (Care Compare)
120 Charlois Blvd
Winston Salem, NC 27103-1562
Phone (336) 765-5664
14547 Bruce B Downs Blvd
Tampa, FL 33613-2709
2352 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9203
38101 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 715-0195
38103 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 778-0414
38105 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 815-5380
38107 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (813) 979-0440
38135 Market Square Dr
Zephyrhills, FL 33542-7505
5347 Main St
Suite 202
New Port Richey, FL 34652-2520
Phone (727) 841-0515
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9104634 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Medical Clinic, LLC | Current | Accepting new patients | |
| Ohi West Medical Group II LLC | Current | Accepting new patients | |
| Ohi West Medical Group II LLC | Current | Accepting new patients | |
| Florida Medical Clinic LLC | Current | Accepting new patients | |
| Ohi West Medical Group II LLC | Past | Accepting new patients |
Locations
14547 Bruce B Downs Blvd
Tampa, FL 33613
Phone (800) 242-5080
14547 Bruce B Downs Blvd
Ste C
Tampa, FL 33613
Phone (813) 979-0440
38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188
38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
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 and National Provider Directory roles.
-
- General Practice Physician
- Zephyrhills, FL
- NPI 1982381299
-
- Clinic/Center
- Zephyrhills, FL
- NPI 1821055690
-
- Pharmacy
- Zephyrhills, FL
- NPI 1669548020
-
- Durable Medical Equipment & Medical Supplies
- Wesley Chapel, FL
- NPI 1427814847
-
- Physiological Laboratory
- Zephyrhills, FL
- NPI 1679344394
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1053321919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446076800000",
"number": "1659535789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38135 MARKET SQ",
"city": "ZEPHYRHILLS",
"state": "FL",
"postal_code": "335427505",
"telephone_number": "813-528-4975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14547 BRUCE B DOWNS BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336132709",
"telephone_number": "813-979-0440",
"fax_number": "813-355-5054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "JOSH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-17",
"last_updated": "2015-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9104634",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000340900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00982255",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.