Individual provider Active NPI

Camden Gillie

  • Student in an Organized Health Care Education/Training Program
  • Arlington, VA
National Provider Identifier
1811805930
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4040 Fairfax Dr Ste 120
Arlington, VA 22203-1613
Phone
(703) 292-4060
NPI assigned
Aug 31, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4040 Fairfax Dr Ste 120
Arlington, VA 22203-1613

Mailing address

21389 Sturman PL
Broadlands, VA 20148-3622
Phone (571) 442-2595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1811805930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21389 STURMAN PL",
            "city": "BROADLANDS",
            "state": "VA",
            "postal_code": "201483622",
            "telephone_number": "571-442-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 FAIRFAX DR STE 120",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031613",
            "telephone_number": "703-292-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIE",
        "first_name": "CAMDEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.