Individual provider Active NPI

Heather Ward Gillian

  • Speech-Language Pathologist
  • Bluefield, VA
National Provider Identifier
1669597456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202005013 Issued in VA
Practice address
Westwood Medical Park
Bluefield, VA 24605
Phone
(276) 322-5439
NPI assigned
Mar 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202005013 VA Primary
Speech-Language Pathologist 235Z00000X 0782 WV

Addresses

Primary practice location

Westwood Medical Park
Bluefield, VA 24605

Mailing address

149 Diamond CT
Beckley, WV 25801-9094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625002151 WV Practitioner - Qualified Speech Language Pathologist 7214242569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2202005013VAMDSpeech-Language Pathologist
0782WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Apr 5, 2025 Accepting new patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Apr 5, 2025 Accepting new patients

Locations

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669597456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 DIAMOND CT",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258019094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WESTWOOD MEDICAL PARK",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "24605",
            "telephone_number": "276-322-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAN",
        "first_name": "HEATHER",
        "middle_name": "WARD",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202005013",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "0782",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluefield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.