Active NPI
Theresa M Gilliam
- Occupational Therapist
- Phoenix, AZ
National Provider Identifier
1700946365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0147
- Practice address
- 124 W Thomas Rd
Phoenix, AZ 85013-4405 - Phone
- (602) 406-6464
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0147 | AZ | Primary |
Addresses
Primary practice location
124 W Thomas Rd
Phoenix, AZ 85013-4405
Mailing address
3200 N Central Ave
Suite 900
Phoenix, AZ 85012-2425
Phone (602) 406-3729
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 95.59 of 100
- Quality
- 81.55
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.5
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0147 | AZ | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District Medical Group, Inc | Current | Accepting new patients | |
| District Medical Group, Inc | Current | Accepting new patients | |
| District Medical Group, Inc | Current | Accepting new patients |
Locations
3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520
2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043
3141 N 3rd Ave
Ste 100
Phoenix, AZ 85013
Phone (602) 914-1520
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/75620b41-1ac4-4c73-abd7-1415dc6810c3/
Organizations & group practices 3
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.
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-
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- NPI 1144624339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700946365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 N CENTRAL AVE",
"address_2": "SUITE 900",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122425",
"telephone_number": "602-406-3729",
"fax_number": "602-798-9412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 W THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134405",
"telephone_number": "602-406-6464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "THERESA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "0147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
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.
- 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.