Individual provider Active NPI

Matthew Charles Gill, M.D.

  • Anesthesiology Physician
  • Memphis, TN
National Provider Identifier
1699822833
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
55476 Issued in TN
Practice address
5545 Murray Ave Ste 130
Memphis, TN 38119-3861
Phone
(901) 682-6828
NPI assigned
Jan 3, 2007
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 60082241 WA
Anesthesiology Physician 207L00000X 55476 TN Primary
Anesthesiology Physician 207L00000X 9261078 ID
Aerospace Medicine Physician 2083A0100X 054379 GA

Addresses

Primary practice location

5545 Murray Ave Ste 130
Memphis, TN 38119-3861

Mailing address

PO Box 171181
Memphis, TN 38187-1181
Phone (901) 682-6828

Other practice location 1

801 Pole Line Rd W
Twin Falls, ID 83301-5810
Phone (208) 814-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, ID3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170510001100 TN Practitioner - Anesthesiology 7517191158 Reassigns benefits to 1 organization
I20220301000369 MS Practitioner - Anesthesiology 7517191158 Reassigns benefits to 1 organization
I20250103001794 ID Practitioner - Anesthesiology 7517191158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

575 Pole Line Rd W
Twin Falls, ID 83301-9998
Phone (208) 814-9200

746 N College Rd
Twin Falls, ID 83301-3486

801 Pole Line Rd W
Twin Falls, ID 83301-5810

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55476TNMDAnesthesiology Physician
60082241WAMDAnesthesiology Physician
054379GAMDAerospace Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Pain Management LLC CurrentSince Dec 8, 2024 Accepting new patients
St Luke's Clinic LLC CurrentSince Nov 14, 2024 Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD Past Accepting new patients
East Memphis Anesthesia Services, PLLC PastSince Feb 1, 2022 Accepting new patients

Locations

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000

1068 Cresthaven Rd
Ste 150
Memphis, TN 38119
Phone (205) 789-5982

5545 Murray Ave
Ste 130
Memphis, TN 38119

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 1

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1699822833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171181",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381871181",
            "telephone_number": "901-682-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 MURRAY AVE STE 130",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193861",
            "telephone_number": "901-682-6828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Pole Line Rd W",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833015810",
            "country_code": "US",
            "telephone_number": "208-814-2400",
            "fax_number": "208-733-9463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "MATTHEW",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "60082241",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "55476",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ID",
            "license": "9261078",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "GA",
            "license": "054379",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.