Stephanie Rae Gillis, MS, NP-C, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R169531 Issued in MD

Practice address

3300 Centennial LN
Ellicott City, MD 21042-3600

Phone

(866) 389-2727

NPI assigned

Sep 29, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

Practice roles

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.

• Rays of Hope Mental Health Services LLC

  • Psychiatry Physician
  • Ellicott City, MD
  • NPI 1053141325
  NPD Authorized official

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1790069490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3159 PINE ORCHARD LN APT 302",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424223",
            "telephone_number": "443-420-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 CENTENNIAL LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423600",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "STEPHANIE",
        "middle_name": "RAE",
        "credential": "MS, NP-C, CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R169531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Gibbons Lesko, SPEECH-LANGUAGE PATH
• Faith Gibson, LCPC
• Heidi T Gido
• Gift Hill Healthcare
• Gilbart Dental Care of Ellicott City LLC
• Gina M. Rassa, LCPC, Inc.
• Deborah Irene Gioia-Hasick, PHD, LCSW-C
• Nicholas Girardi, MD
• Ivy Giserman-Kiss, PHD
• Peter Gitei, B.PHARM

• Family Nurse Practitioner in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.