Active NPI
Tamara Gilliam
- Phlebotomy Technician
- Conyers, GA
National Provider Identifier
1871477935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- CN0028881613
- Practice address
- 2365 Wall St SE # 207
Conyers, GA 30013-2197 - Phone
- (678) 887-1323
- Fax
- (404) 570-4957
- NPI assigned
- Aug 2, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | CN0028881613 | GA | Primary |
Addresses
Primary practice location
2365 Wall St SE # 207
Conyers, GA 30013-2197
Mailing address
2274 Salem Rd SE Ste 106
Conyers, GA 30013-2295
Phone (678) 780-4129
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CN0028881613 | GA | MD | Phlebotomy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754092800000",
"number": "1871477935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2274 SALEM RD SE STE 106",
"city": "CONYERS",
"state": "GA",
"postal_code": "300132295",
"telephone_number": "678-780-4129",
"fax_number": "470-570-4957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2365 WALL ST SE # 207",
"city": "CONYERS",
"state": "GA",
"postal_code": "300132197",
"telephone_number": "678-887-1323",
"fax_number": "404-570-4957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "TAMARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-02",
"last_updated": "2025-08-02",
"certification_date": "2025-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "GA",
"license": "CN0028881613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conyers, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.