Individual provider Active NPI

Barry Lee Gilliam Jr.

  • Case Manager/Care Coordinator
  • Oklahoma City, OK
National Provider Identifier
1962779256
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
4100 Newport Ave
Oklahoma City, OK 73112-6334
Phone
(405) 943-2273
Fax
(405) 947-8262
NPI assigned
Nov 30, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holloway Group Inc PastSince Mar 26, 2022 Accepting new patients
Hav -Tap, Inc. Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

4100 Newport Ave
Oklahoma City, OK 73112-6334

Mailing address

4100 Newport Ave
Oklahoma City, OK 73112
Phone (405) 943-2273

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 30, 2011.

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1962779256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 NEWPORT AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73112",
            "telephone_number": "405-943-2273",
            "fax_number": "405-947-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 NEWPORT AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731126334",
            "telephone_number": "405-943-2273",
            "fax_number": "405-947-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "BARRY",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.