Organization Active NPI

Dr Gary L Gillen

  • Family Medicine Physician
  • Circleville, OH
National Provider Identifier
1962601369
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DR GARY L GILLEN
Practice address
131 Lewis Ave
Circleville, OH 43113
Phone
(740) 420-9288
Fax
(740) 420-3070
NPI assigned
Jul 16, 2007
Last updated
Jul 16, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Authorized official

Name
Dr. Gary Lee Gillen, MD
Title
Owner Sole Proprietor
Phone
(740) 420-9288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OH Primary

Addresses

Primary practice location

131 Lewis Ave
Circleville, OH 43113

Mailing address

PO Box 39
131 Lewis Ave
Circleville, OH 43113
Phone (740) 420-9288

Other identifiers 1

IdentifierTypeStateIssuer
GA9339531OtherOHMEDICARE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1962601369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39",
            "address_2": "131 LEWIS AVE",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "43113",
            "telephone_number": "740-420-9288",
            "fax_number": "740-420-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 LEWIS AVE",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "43113",
            "telephone_number": "740-420-9288",
            "fax_number": "740-420-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR GARY L GILLEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "GILLEN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER  SOLE PROPRIETOR",
        "authorized_official_telephone_number": "740-420-9288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GA9339531",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Circleville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.

Verify at the official NPI Registry.