Karl Eric Forsberg Gilliam, MSPT,CSCS,CI

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22144 Issued in FL

Practice address

12670 Creekside LN
Suite 202
Fort Myers, FL 33919-3359

Phone

(239) 267-2263

NPI assigned

Jul 19, 2006

Last updated

Apr 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1902825672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 RUE LABEAU CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339137513",
            "telephone_number": "239-369-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12670 CREEKSIDE LN",
            "address_2": "SUITE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193359",
            "telephone_number": "239-267-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "KARL",
        "middle_name": "ERIC FORSBERG",
        "name_prefix": "Mr.",
        "credential": "MSPT,CSCS,CI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "22144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1902825672",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Val Rae Gill, L.M.H.C.
• Jamie Gilles, LCSW
• Alyssa Gillespie
• Jeniffer Gillespie
• Mark E Gillespie, MD
• Melissa Ann Gilliam, PA-C
• Keith Alan Gillis, APRN
• Taryn Benson Gillis, NP-C
• Natalie A Gillson, M.D.
• Olga Gilman, PA-C

• Physical Therapist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.