Penny Gilliam, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

746269 Issued in TX

Practice address

6606 LBJ Fwy Ste 200
Dallas, TX 75240

Phone

(972) 715-5000

Fax

(972) 715-9976

NPI assigned

Aug 17, 2006

Last updated

Jun 11, 2018By the provider in NPPES

Sex

Female

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 7

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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

• Endo Sedation LLC

  • Certified Registered Nurse Anesthetist
  • Keller, TX
  • NPI 1588931174

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• U. S. Anesthesia Partners of Texas, P.a.,

  dba Greater Houston Anesthesiology, P.A.

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1548208564

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Endo Sedation LLC

  • Certified Registered Nurse Anesthetist
  • Flower Mound, TX
  • NPI 1114270931

  Nurse Anesthetist, Certified Registered

  NPD
• Endo Sedation LLC

  • Certified Registered Nurse Anesthetist
  • Beaumont, TX
  • NPI 1548817471

  Nurse Anesthetist, Certified Registered

  NPD
• U S Anesthesia Partners of Texas, PA

  • Interventional Pain Medicine Physician
  • Addison, TX
  • NPI 1053800391

  Nurse Anesthetist, Certified Registered

  NPD
• Lake County Anesthesia Associates PA

  • Pain Medicine (Anesthesiology) Physician
  • Leesburg, FL
  • NPI 1033163464

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1942314299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 LBJ FWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75240",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "PENNY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "746269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200877301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200877303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301352900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200877302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00786663",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8008UU",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "G1916",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Joy Gillespie
• Arve Ward Gillette, M.D.
• Elisha Gilley, LMSW
• Elizabeth Gilley
• Gilley's Pharmacy, Inc
• Tristan Lyn Gilliam, OTR
• Vanessa Gilliam, M.ED., BCBA, LBA
• Derrick Lynn Gillians, RRT
• Mark H. Gillie, M.D.
• George R Gilligan, M.D.

• Certified Registered Nurse Anesthetist in Dallas, TX
• Providers in Dallas, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.