Active NPI
Rebecca L Gillespie, PSYD
- Clinical Psychologist
- Greenville, NC
National Provider Identifier
1790032399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5761
- Practice address
- 313 Clifton St
Greenville, NC 27858-5008 - Phone
- (252) 353-0100
- NPI assigned
- Aug 14, 2012
- Last updated
- Apr 23, 2024
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5761 | NC | Primary |
Addresses
Primary practice location
313 Clifton St
Greenville, NC 27858-5008
Mailing address
1320 Wisconsin Ave
Racine, WI 53403-1978
Phone (262) 687-4011
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5761 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713830400000",
"number": "1790032399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 WISCONSIN AVE",
"city": "RACINE",
"state": "WI",
"postal_code": "534031978",
"telephone_number": "262-687-4011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 CLIFTON ST",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278585008",
"telephone_number": "252-353-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLESPIE",
"first_name": "REBECCA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-14",
"last_updated": "2024-04-23",
"certification_date": "2024-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "5761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.