David Robert Gill, MSHS, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

006913 Issued in GA

Practice address

1900 Tebeau St
Satilla Mayo Emergency Department
Waycross, GA 31501-6357

Phone

(912) 283-3030

Fax

(727) 507-3618

NPI assigned

Jul 19, 2013

Last updated

May 1, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ergent Med PrimeGroup PAC ID 8820362189, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: david.gill@241121034764292.direct.elationemr.com

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.

• Ergent Med Prime

  • Primary Care Clinic/Center
  • Brunswick, GA
  • NPI 1811345390
  Medicare reassignment Care Compare group
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment
• Advanced Pediatric Specialists LLC

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1073046397
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Brunswick Campus

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720
  Care Compare affiliation

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1952743932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD",
            "address_2": "SUITE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401331",
            "telephone_number": "800-362-2731",
            "fax_number": "214-712-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TEBEAU ST",
            "address_2": "SATILLA MAYO EMERGENCY DEPARTMENT",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016357",
            "telephone_number": "912-283-3030",
            "fax_number": "727-507-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MSHS, PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-19",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia Infectious Disease Consultants
• Georgia Spine & Pain Centers
• Olivia Ruth Gibson, RN/APRN
• Kelly Matthew Gilbert, D.C.
• Robert Allen Giles Jr., MD
• Roger Robert Gillis, LPC
• Angela Michelle Given, PHARM.D., R.PH
• Staci Shonte' Glee, PT, DPT
• Lisa F Goedert, CRNA
• Hector Kevin Gonzalez Fajardo, MD

• Physician Assistant in Waycross, GA
• Providers in Waycross, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.
• 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.