Active NPI
David H Gilliland
- Vascular Surgery Physician
- Tupelo, MS
National Provider Identifier
1902881899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 11724
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00110162 | Medicaid | MS |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgery Associates PA | Surgery | Current | 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.
-
- Surgery Physician
- Tupelo, MS
- NPI 1790760692
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.