Individual provider Active NPI

Cameron Alexander Gillespie, MD

  • Otolaryngic Allergy Physician
  • Galax, VA
National Provider Identifier
1790747889
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
010-1026376 Issued in VA
Practice address
104 Doctors Park
Galax, VA 24333-2276
Phone
(276) 236-5161
NPI assigned
Apr 4, 2006
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X PT22030 ND
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 010-1026376 VA
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 010-1026376 VA
Otolaryngic Allergy Physician 207YX0602X 010-1026376 VA Primary

Addresses

Primary practice location

104 Doctors Park
Galax, VA 24333-2276

Mailing address

PO Box 1337
Galax, VA 24333-1337
Phone (276) 236-3210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170726003488 NC Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 9234208109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Virginia School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

233 Doctors St
Sparta, NC 28675-9247
Phone (336) 372-5511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28035NCMDPharmacist
PT22030NDMDOtolaryngology Physician
010-1026376VAMDUndersea and Hyperbaric Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Sep 1, 2025 Accepting new patients
Regional Employee Assistance Program Inc Otolaryngology CurrentSince Sep 1, 2025 Accepting new patients
Alleghany County Memorial Hospital Inc CurrentSince May 5, 2017 Accepting new patients
Regional Employee Assistance Program Inc Otolaryngology Current Accepting new patients
Twin County Family Care Centers Inc Past Accepting new patients
DLP Twin County Physician Practices LLC Past Accepting new patients

Locations

233 Doctors St
Sparta, NC 28675
Phone (336) 372-3223

1602 E Houston St
Ste C
Beeville, TX 78102
Phone (361) 354-2900

101 Medical Dr
Victoria, TX 77904
Phone (361) 573-6100

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

605 E San Antonio St
Ste 508E
Victoria, TX 77901
Phone (361) 485-0051

Interoperability endpoints

  • Direct secure messaging: cameron.gillespie.1@1902.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1790747889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243331337",
            "telephone_number": "276-236-3210",
            "fax_number": "276-236-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 DOCTORS PARK",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332276",
            "telephone_number": "276-236-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "CAMERON",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ND",
            "license": "PT22030",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "VA",
            "license": "010-1026376",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "VA",
            "license": "010-1026376",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "VA",
            "license": "010-1026376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galax, VA

Sources for this page

Verify at the official NPI Registry.