Kerry Gillette

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0032530 Issued in OH

Practice address

547 E 11TH Ave
Columbus, OH 43211-2603

Phone

(614) 224-4506

NPI assigned

Jul 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Compdrug

  • Methadone Clinic
  • Columbus, OH
  • NPI 1134184658
  Medicare reassignment NPD
• Boulder Care Provider Group PA

  • Addiction Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1649838590

  OH

  Medicare reassignment NPD
• Compdrug

  • Methadone Clinic
  • Columbus, OH
  • NPI 1366220394
  NPD (past)
• Compdrug

  • Adult Mental Health Clinic/Center
  • Columbus, OH
  • NPI 1598543506
  NPD (past)

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1801522651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 E 11TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432112603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 E 11TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432112603",
            "telephone_number": "614-224-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "KERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "OH",
            "license": "307303",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0032530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Gillespie
• Shannon Laurel Gillespie, PSYD
• Thomas Eugene Gillespie, DDS
• Erika Gillette
• Jennifer Gillette
• Mary Kathleen Gillette, LISW
• Nathan Gillette, PRS
• Chalana Gillham
• Jodi Gilliam-Harmon, L.C.D.C. III
• Antwan Gilliam

• Psychiatric/Mental Health Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.