Nathan Gillette, PRS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

003340 Issued in OH

Practice address

4177 E Broad St
Columbus, OH 43213-1217

Phone

(614) 697-1313

NPI assigned

Jun 22, 2022

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1679204465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432133028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4177 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131217",
            "telephone_number": "614-697-1313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4214 E Main St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432133028",
            "country_code": "US",
            "telephone_number": "330-334-6903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "NATHAN",
        "credential": "PRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "003340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Eugene Gillespie, DDS
• Erika Gillette
• Jennifer Gillette
• Kerry Gillette
• Mary Kathleen Gillette, LISW
• Chalana Gillham
• Jodi Gilliam-Harmon, L.C.D.C. III
• Antwan Gilliam
• Christopher Gilliam, MD
• Colleen Gilliam

• Peer Specialist in Columbus, OH
• Providers in Columbus, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.