Individual provider Active NPI

Bria Marie Gillespie, PA

  • Physician Assistant
  • Jackson, WY
National Provider Identifier
1902536113
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1040 Issued in WY
Practice address
1415 S Hwy 89
Jackson, WY 83001-8515
Phone
(073) 739-8999
Fax
(307) 739-4811
NPI assigned
Jun 13, 2022
Last updated
May 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1040 WY Primary

Addresses

Primary practice location

1415 S Hwy 89
Jackson, WY 83001-8515

Mailing address

PO Box 428
Jackson, WY 83001-0428
Phone (307) 739-7584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20230202002101 WY Practitioner - Physician Assistant 4082086939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Teton County Hospital DistrictGroup PAC ID 4880582295, 107 clinicians

Practice addresses (Care Compare)

1415 S Hwy 89
Jackson, WY 83001-8515
Phone (307) 739-8999

3345 W Cody LN
Unit 9
Teton Village, WY 83025-0544
Phone (307) 739-7346

625 E Broadway Ave
Jackson, WY 83001-8642
Phone (307) 733-3636

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.82 of 100Reported as group
Quality
67.1
Promoting interoperability
98
Improvement activities
40
Cost
73.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1040WYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Teton County Hospital District CurrentSince Jan 25, 2023 Accepting new patients
Teton County Hospital District CurrentSince Jan 25, 2023 Accepting new patients

Organizations & group practices 2

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 1

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1902536113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830010428",
            "telephone_number": "307-739-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 S HWY 89",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018515",
            "telephone_number": "073-739-8999",
            "fax_number": "307-739-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "BRIA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "PA1040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

Verify at the official NPI Registry.