Individual provider Active NPI

Abigail Gilliam, DPT

  • Physical Therapist
  • Hawkinsville, GA
National Provider Identifier
1740963453
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016754 Issued in GA
Practice address
2 Mashburn St
Hawkinsville, GA 31036-4961
Phone
(478) 783-4460
NPI assigned
Aug 9, 2023
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Physical Therapist 225100000X PT016754 GA Primary

Addresses

Primary practice location

2 Mashburn St
Hawkinsville, GA 31036-4961

Mailing address

415 Town Park Blvd
Evans, GA 30809-3487

Other practice location 1

415 Town Park Blvd
Evans, GA 30809-3487
Phone (706) 868-1707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230926002326 GA Practitioner - Physical Therapist in Private Practice 8921452889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Orthopedic Surgery and Sports Medicine, P.C.Group PAC ID 5092703835, 19 clinicians

Practice addresses (Care Compare)

3051 Watson Blvd
Suite 525
Warner Robins, GA 31093-8556
Phone (478) 953-4563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Rehabilitation Services, LLC Physical Therapist CurrentSince Aug 7, 2023 Accepting new patients
Houston Orthopedic Surgery & Sports Medicine, P.C. CurrentSince Sep 5, 2024 Accepting new patients
Houston Orthopedic Surgery & Sports Medicine, P.C. CurrentSince Sep 5, 2024 Accepting new patients
Elite Sport & Spine Physical Therapy, Inc. Physical Therapist PastSince Jul 22, 2025 Accepting new patients

Locations

2115 Windsor Spring Rd
Ste 2300
Augusta, GA 30906

415 Town Park Blvd
Evans, GA 30809
Phone (706) 690-4372

1013 Main St
Perry, GA 31069
Phone (478) 953-4563

3051 Watson Blvd
Warner Robins, GA 31093
Phone (478) 953-4563

3051 Watson Blvd
Ste 525
Warner Robins, GA 31093
Phone (478) 953-4563

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1740963453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 TOWN PARK BLVD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MASHBURN ST",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310364961",
            "telephone_number": "478-783-4460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 Town Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308093487",
            "country_code": "US",
            "telephone_number": "706-868-1707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "ABIGAIL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.