Active NPI
Abigail Gilliam
- Physical Medicine & Rehabilitation Physician
- Flint, MI
National Provider Identifier
1962112672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 5501019183
- Practice address
- 1 Hurley PLZ
Flint, MI 48503-5902 - Phone
- (810) 262-6744
- NPI assigned
- Dec 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 5501019183 | MI | Primary |
Addresses
Primary practice location
1 Hurley PLZ
Flint, MI 48503-5902
Mailing address
683 Beardon
Lake Orion, MI 48362-2001
Phone (304) 982-0621
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501019183 | MI | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670198400000",
"number": "1962112672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "683 BEARDON",
"city": "LAKE ORION",
"state": "MI",
"postal_code": "483622001",
"telephone_number": "304-982-0621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HURLEY PLZ",
"city": "FLINT",
"state": "MI",
"postal_code": "485035902",
"telephone_number": "810-262-6744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "ABIGAIL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-05",
"last_updated": "2022-12-05",
"certification_date": "2022-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MI",
"license": "5501019183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.