Individual provider Active NPI

Julie Gilson, PA-C

  • Medical Physician Assistant
  • Perrysburg, OH
National Provider Identifier
1962873331
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.004363 Issued in OH
Practice address
28555 Starbright Blvd Ste B
Perrysburg, OH 43551-5662
Phone
(419) 931-3030
Fax
(419) 931-3048
NPI assigned
Oct 12, 2015
Last updated
Oct 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50.004363 OH Primary

Addresses

Primary practice location

28555 Starbright Blvd Ste B
Perrysburg, OH 43551-5662

Mailing address

28555 Starbright Blvd Ste B
Perrysburg, OH 43551-5662
Phone (419) 931-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20151105000495 OH Practitioner - Physician Assistant 0547570459 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50.004363OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians-North LLC CurrentSince Nov 30, 2018 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Nov 30, 2018 Accepting new patients

Locations

28555 Starbright Blvd
Ste B
Perrysburg, OH 43551
Phone (419) 931-3030

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1962873331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28555 STARBRIGHT BLVD STE B",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515662",
            "telephone_number": "419-931-3030",
            "fax_number": "419-931-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28555 STARBRIGHT BLVD STE B",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515662",
            "telephone_number": "419-931-3030",
            "fax_number": "419-931-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILSON",
        "first_name": "JULIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.004363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.