Individual provider Active NPI

Stephanie Y Gilliam, CNM

  • Advanced Practice Midwife
  • Gastonia, NC
National Provider Identifier
1811243967
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
504 Issued in NC
Practice address
1225 E Garrison Blvd
Gastonia, NC 28054-5115
Phone
(704) 865-7416
Fax
(704) 865-7232
NPI assigned
Jul 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 504 NC Primary

Addresses

Primary practice location

1225 E Garrison Blvd
Gastonia, NC 28054-5115

Mailing address

1225 E Garrison Blvd
Gastonia, NC 28054-5115
Phone (704) 865-7416

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120912000296 NC Practitioner - Certified Nurse Midwife (CNM) 1153579404 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical CenterGroup PAC ID 0547178907, 105 clinicians
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

3070 11TH Ave Dr SE
Hickory, NC 28602-8336
Phone (828) 466-7196

620 Summit Crossing PL
Suite 108a
Gastonia, NC 28054-2189
Phone (704) 865-2229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Current Accepting new patients
Catawba Valley Medical Center CurrentSince Jul 18, 2022 Accepting new patients
Catawba Valley Medical Center CurrentSince Jul 18, 2022 Accepting new patients
Caromont Medical Group Inc CurrentSince Mar 1, 2019 Accepting new patients
Caromont Medical Group Inc CurrentSince Mar 1, 2019 Accepting new patients
Catawba Valley Medical Center Past Accepting new patients
Caromont Medical Group Inc Past Accepting new patients

Locations

1225 E Garrison Blvd
Gastonia, NC 28054
Phone (704) 865-7416

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

2240 Remount Rd
Gastonia, NC 28054
Phone (704) 671-5311

620 Summit Crossing Pl
Ste 108A
Gastonia, NC 28054
Phone (704) 865-2229

3070 11th Avenue Dr SE
Hickory, NC 28602
Phone (828) 466-7196

519 Nautical Dr
Ste 100C
Clover, SC 29710
Phone (704) 865-7416

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1811243967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545115",
            "telephone_number": "704-865-7416",
            "fax_number": "704-865-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545115",
            "telephone_number": "704-865-7416",
            "fax_number": "704-865-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "STEPHANIE",
        "middle_name": "Y",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NC",
            "license": "504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.