Individual provider Active NPI

David H Gilliland

  • Vascular Surgery Physician
  • Tupelo, MS
National Provider Identifier
1902881899
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
11724 Issued in MS
Practice address
440 Pegram Dr
Tupelo, MS 38801-6319
Phone
(662) 844-5344
Fax
(662) 844-5363
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 11724 MS
Vascular Surgery Physician 2086S0129X 11724 MS Primary

Addresses

Primary practice location

440 Pegram Dr
Tupelo, MS 38801-6319

Mailing address

440 Pegram Dr
Tupelo, MS 38801-6319
Phone (662) 844-5344

Other identifiers 1

IdentifierTypeStateIssuer
00110162MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100729000012 MS Practitioner - General SurgeryPractitioner - Vascular Surgery 7113909342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Surgery Associates PA Surgery CurrentSince Nov 1, 1988 Accepting new patients

Locations

440 Pegram Dr
Tupelo, MS 38801
Phone (662) 844-5344

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902881899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 PEGRAM DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016319",
            "telephone_number": "662-844-5344",
            "fax_number": "662-844-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 PEGRAM DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016319",
            "telephone_number": "662-844-5344",
            "fax_number": "662-844-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "DAVID",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "11724",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MS",
            "license": "11724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00110162",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.