Active NPI
Michael D Gillies, MD
- Emergency Medicine Physician
- Hood River, OR
National Provider Identifier
1912181702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD11243
- Practice address
- 811 13TH St
Hood River, OR 97031-1204 - Phone
- (541) 387-6455
- NPI assigned
- Dec 28, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD11243 | OR | Primary |
Addresses
Primary practice location
811 13TH St
Hood River, OR 97031-1204
Mailing address
PO Box 3390
Portland, OR 97208-3390
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019161 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11243 | OR | MD | Reflexologist |
| MD11243 | OR | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198800000000",
"number": "1912181702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3390",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 13TH ST",
"city": "HOOD RIVER",
"state": "OR",
"postal_code": "970311204",
"telephone_number": "541-387-6455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIES",
"first_name": "MICHAEL",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-28",
"last_updated": "2007-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OR",
"license": "MD11243",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019161",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hood River, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.