Anita Bliss Gilliam, MA,LOTR

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

Z10042 Issued in LA

Practice address

1213 Capilano Dr
Shreveport, LA 71106-8286

Phone

(318) 797-6492

Fax

(318) 797-3304

NPI assigned

Apr 6, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1902928013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 CAPILANO DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068286",
            "telephone_number": "318-797-6492",
            "fax_number": "318-797-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 CAPILANO DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068286",
            "telephone_number": "318-797-6492",
            "fax_number": "318-797-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "ANITA",
        "middle_name": "BLISS",
        "name_prefix": "Mrs.",
        "credential": "MA,LOTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "LA",
            "license": "Z10042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1307874",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakimberly Gill, B.A.
• Sargit S Gill, MD
• Allie Gillen
• Gilford Lee Gillen Jr., LPC
• Carlee Gilley, DDS
• Kristen Gilliam
• Rebecca Gilliam
• Shamora Shaw'Nae Gilliam, MHS
• Shelby Gilliam
• Paris Gillum

• Pediatric Occupational Therapist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Pediatric Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.