Individual provider Active NPI

Gina C. Bird, P.A.

  • Medical Physician Assistant
  • Champaign, IL
National Provider Identifier
1902813454
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085002358 Issued in IL
Practice address
101 W University Ave
Champaign, IL 61820-3981
Phone
(217) 366-1248
Fax
(217) 366-6100
NPI assigned
Aug 1, 2006
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085002358 IL Primary

Addresses

Primary practice location

101 W University Ave
Champaign, IL 61820-3981

Mailing address

101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-1248

Other identifiers 2

IdentifierTypeStateIssuer
P00168412OtherILRAILROAD MEDICARE
434110OtherILMEDICARE GROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gbirdpa288424@CarleHieDirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20050128000496 IL Practitioner - Physician Assistant 3971553710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christie Clinic, PLLCGroup PAC ID 7719899319, 219 clinicians

Practice addresses (Care Compare)

101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-1200

108 Robinson St
Danville, IL 61832-8515
Phone (217) 442-8611

109 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-5180

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christie Clinic, PLLC CurrentSince Oct 25, 2004 Accepting new patients
Illiana Emergency Physicians LLP Past Accepting new patients

Locations

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

405 Sheridan St
Danville, IL 61832
Phone (217) 431-6330

812 N Logan Ave
Danville, IL 61832
Phone (217) 443-5000

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

Interoperability endpoints

  • Direct secure messaging: gbirdpa288424@carlehiedirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1902813454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-1248",
            "fax_number": "217-366-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRD",
        "first_name": "GINA",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085002358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00168412",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "434110",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gbirdpa288424@CarleHieDirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 W University Ave",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618203981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.