Active NPI
Tammy Burrell Gilliam
- Speech-Language Assistant
- Goodyear, AZ
National Provider Identifier
1982261343
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SLPA11664
- Practice address
- 16385 W McKinley St
Goodyear, AZ 85338-6277 - Phone
- (256) 617-1867
- NPI assigned
- May 21, 2019
- Last updated
- May 21, 2019
- 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 |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SLPA11664 | AZ | Primary |
Addresses
Primary practice location
16385 W McKinley St
Goodyear, AZ 85338-6277
Mailing address
16385 W McKinley St
Goodyear, AZ 85338-6277
Phone (256) 617-1867
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLPA11664 | AZ | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558396800000",
"number": "1982261343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16385 W MCKINLEY ST",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853386277",
"telephone_number": "256-617-1867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16385 W MCKINLEY ST",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853386277",
"telephone_number": "256-617-1867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRELL GILLIAM",
"first_name": "TAMMY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-21",
"last_updated": "2019-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "SLPA11664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.