Individual provider Active NPI

Gillian Marie Williams, PNP

  • Pediatric Nurse Practitioner
  • Upland, CA
National Provider Identifier
1730589169
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
22163 Issued in CA
Practice address
440 N Mountain Ave
Suite 112
Upland, CA 91786-5183
Phone
(909) 931-1313
Fax
(909) 920-3883
NPI assigned
Sep 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 664000 CA
Pediatric Nurse Practitioner 363LP0200X 22163 CA Primary

Addresses

Primary practice location

440 N Mountain Ave
Suite 112
Upland, CA 91786-5183

Mailing address

440 N Mountain Ave
Suite 112
Upland, CA 91786-5183
Phone (909) 931-1313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
664000CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rene Salhab MD Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1730589169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N MOUNTAIN AVE",
            "address_2": "SUITE 112",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865183",
            "telephone_number": "909-931-1313",
            "fax_number": "909-920-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 N MOUNTAIN AVE",
            "address_2": "SUITE 112",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865183",
            "telephone_number": "909-931-1313",
            "fax_number": "909-920-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GILLIAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "664000",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "22163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.