Gloria Maria Guillen, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209.020480 Issued in IA

Practice address

4600 3Rd St
Moline, IL 61265-6106

Phone

(309) 779-2031

NPI assigned

Jan 23, 2020

Sex

Female

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

Enrolled in IL, IA, WA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Northwest Iowa Hospital CorporationGroup PAC ID 0749198026, 139 clinicians

Forefront-Rosenzweig Medical Services Professional CorporationGroup PAC ID 1052697455, 34 clinicians

Allen Memorial Hospital CorporationGroup PAC ID 4284546045, 149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Regional Medical Center Hospital, Sioux City, IA, CCN 160146

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gguillen427967@direct.unitypoint.org

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.

• Allen Memorial Hospital Corporation

  • Women's Health Nurse Practitioner
  • Waterloo, IA
  • NPI 1891772927
  Medicare reassignment Care Compare group NPD
• Northwest Iowa Hospital Corporation

  • Emergency Medical Services (Emergency Medicine) Physician
  • Sioux City, IA
  • NPI 1215962550
  Medicare reassignment Care Compare group NPD
• Forefront-Rosenzweig Medical Services Professional Corporation

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1588101745

  IL, WA

  Medicare reassignment Care Compare group
• The Robert Young Center for Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rock Island, IL
  • NPI 1710276399
  Medicare reassignment NPD
• The Robert Young Center for Community Mental Health

  • Mental Health Counselor
  • Rock Island, IL
  • NPI 1972272516

  IA

  Medicare reassignment NPD
• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134
  Medicare reassignment NPD
• Forefront Telecare Inc

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1174035612

  IA

  Medicare reassignment NPD
• Vera French Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Davenport, IA
  • NPI 1245291129
  Medicare reassignment NPD
• Access Telecare, PLLC

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1013303080

  IA, IL, WA

  Medicare reassignment
• The Finley Hospital

  • Family Medicine Physician
  • Dubuque, IA
  • NPI 1073560462
  Medicare reassignment
• Trinity Medical Center

  • Psychiatry Physician
  • Rock Island, IL
  • NPI 1033163829
  NPD
• Allen Memorial Hospital Corporation

  • Emergency Medicine Physician
  • Waterloo, IA
  • NPI 1346292521
  NPD

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

• Northwest Iowa Hospital Corporation

  • General Acute Care Hospital
  • Sioux City, IA
  • NPI 1962594622
  Care Compare affiliation

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1659901106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 RIDGEWOOD AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528033453",
            "telephone_number": "956-367-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 3RD ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656106",
            "telephone_number": "309-779-2031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4622 Progress Dr",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528073426",
            "country_code": "US",
            "telephone_number": "563-742-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUILLEN",
        "first_name": "GLORIA",
        "middle_name": "MARIA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "209.020480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Greer, RDN, LDN
• Gretchen L. Cromer, MD PC
• Gale Rene' Griffith, PT
• Krista Grizzle
• Penny Toshie Grunder, RPSGT
• Eirik Gustafson
• Jasmine Guy
• Linda C Haessler, P.A.-C.
• Yolla Haibe, MD
• Jeffrey R Hallman, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Moline, IL
• Providers in Moline, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.

Verify at the official NPI Registry.