Jaime M Gilliam, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 29672 Issued in CA

Practice address

3179 Hamner Ave
Suite 7
Norco, CA 92860-1983

Phone

(951) 736-5646

NPI assigned

Apr 10, 2006

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

Other names 1

• Miss Jaime M Baxter Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bodybasics Physical Therapy IncGroup PAC ID 2365413861, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bodybasics Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Norco, CA
  • NPI 1487651097

  CA

  Medicare reassignment Care Compare group NPD
• Bodybasics Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Corona, CA
  • NPI 1194904243
  NPD (past)
• West Coast Spine Restoration Center, Inc

  • Physical Therapist
  • Riverside, CA
  • NPI 1992887616
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1720041759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 RIMCREST DR",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928601174",
            "telephone_number": "951-532-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3179 HAMNER AVE",
            "address_2": "SUITE 7",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928601983",
            "telephone_number": "951-736-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "JAIME",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 29672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "BAXTER",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hamed Ghorbanian, DDS
• Machelise Simone Gibson
• Martha Gibson
• Bernadine D Gill, AAS,CMT
• Kayla Gillespie, OTR/L
• Desire Carpena Giron, RDH
• Jana Marie Given, PSYD
• Katherine Victoria Givens
• Amy Gomez
• Angela Lois Gonzales, M.D.

• All providers in Norco, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.

Verify at the official NPI Registry.