Trenton Devonte' Gilliam

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

Trout Ave
BLDG 159
Groton, CT 06340

Phone

(860) 694-2876

NPI assigned

Aug 9, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1942983705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DEWEY AVE",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403343",
            "telephone_number": "901-849-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TROUT AVE",
            "address_2": "BLDG 159",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-694-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "TRENTON",
        "middle_name": "DEVONTE'",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Gauthier
• General Dynamics
• Christina Elizabeth Gentile, PA-C
• Warren M Geruso, DC
• Anthony J Gervasi, IDC
• Elisa Marie Girard, MD
• Catherine E Giroux
• Danielle Montufar Gleason, PSY.D.
• Mary A Glenn, M.D.
• James Rory Glennon, PSY.D.

• Independent Duty Corpsman in Groton, CT
• Providers in Groton, CT by specialty
• Independent Duty Corpsman in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.