MR. PHILLIP SCOTT GILLIAM (NPI# 1841372273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841372273 |
| Entity Type | Individual |
| Full Name | MR. PHILLIP SCOTT GILLIAM |
| Credential | PA |
| Practice Address |
1509 W Truman Rd Independence MO 64050-3436 |
| Mailing Address |
Po Box 838 Shawnee Mission KS 66201-0838 |
| Practice Telephone | 8168366901 |
| Practice Fax Number | 8168364400 |
| Mailing Telephone | 9134694244 |
| Mailing Fax Number | 9134691939 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2019-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 2005017775 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2005017775 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 54 Hospital Dr, Osage Beach, MO 650653050 | 5733488000 | 5733488309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326174558 | Phillip Lee Gilliam | Optometrist | 114 S Sycamore St, Elizabethton, TN 37643-3339 | 2007-02-23 |
| Street Address |
1509 W TRUMAN RD |
| City | INDEPENDENCE |
| State | MO |
| Zip Code | 64050-3436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437131208 | Aulton Dale Chisum | Emergency Medicine | 1509 W Truman Rd, Emergency Department, Independence, MO 64050-3436 | 2005-11-17 |
| 1508947938 | Rebecca D Crawford | Physician Assistant | 1509 W Truman Rd, Independence, MO 64050-3436 | 2006-10-19 |
| 1003997925 | Lisa M Moravac | Physician Assistant | 1509 W Truman Rd, Independence, MO 64050-3436 | 2006-10-18 |
| 1982672432 | Frank R Demarco | Emergency Medicine | 1509 W Truman Rd, Independence, MO 64050-3436 | 2006-03-10 |
| 1467436691 | Harry E Kleiner | Emergency Medicine | 1509 W Truman Rd, Emergency Department, Independence, MO 64050-3436 | 2005-12-01 |
| 1174505580 | Thomas R Coughlin Jr. | Emergency Medicine | 1509 W Truman Rd, Emergency Department, Independence, MO 64050-3436 | 2005-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841698024 | Joshonna Price | Occupational Therapy Assistant | 810 E Walnut, Independence, MO 64050 | 2014-12-19 |
| 1003151770 | Melinda Stegner | Registered Nurse | 3445 South 291 Hwy, Ste 300, Independence, MO 64050 | 2012-12-06 |
| 1194075788 | Healthstat- Independence School District | Preventive Medicine | 1516 W. Maple, Independence, MO 64050 | 2012-09-12 |
| 1568790749 | Charity Faith Morris | Case Manager/Care Coordinator | 314 E Pacific Avenue, Independence, MO 64050 | 2009-11-25 |
| 1225276090 | Best Smile, LLC | Dentist | 651 E 24 Hwy, Independence, MO 64050 | 2009-02-01 |
| 1396982468 | Independence Avenue Dental LLC | Clinic/Center | 1638 West 24 Highway, Independence, MO 64050 | 2009-01-12 |
| 1366640914 | Center for The Developmentally Disabled | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1215 W. Truman Rd, Independence, MO 64050 | 2007-07-05 |
| 1992871883 | Stephen Ervin Dorsch | Family Medicine | 1638 W 24 Hwy, Independence, MO 64050 | 2006-11-24 |
| 1831284801 | Ronald Eugene Jennings | Dentist | 514 S Noland Road, Noland Medical Plaza Suite 120, Independence, MO 64050 | 2006-10-04 |
| 1841393782 | Carmel Hills Healthcare and Rehabilitation Center, LLC | Skilled Nursing Facility | 810 East Walnut, Independence, MO 64050 | 2006-09-06 |
| Find all providers in zip 64050 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912538752 | Karen Anghel | Physician Assistant | 804 S Kisner Dr, Independence, MO 64056-3062 | 2020-01-30 |
| 1295259588 | Lindsey Grant | Physician Assistant | 19550 E 39th St S Ste 410, Independence, MO 64057-2307 | 2017-07-28 |
| 1013451558 | Courtney Adams | Physician Assistant | 19550 E 39th St S, Ste 410, Independence, MO 64057-2358 | 2016-12-16 |
| 1649725714 | Lacey Elizabeth Perez | Physician Assistant | 19600 E 39th St S, Independence, MO 64057-2301 | 2016-08-18 |
| 1083092514 | Shelly Wimmer | Physician Assistant | 1430 Monmouth St, Independence, OR 97351-1127 | 2015-05-17 |
| 1033519830 | Mallory E. Harris | Physician Assistant | 3751 W Main St, Independence, KS 67301-8446 | 2014-08-28 |
| 1942569215 | Stephen Daniel Miller | Physician Assistant | 19550 E 39th St S, Ste 410, Independence, MO 64057-2303 | 2012-05-08 |
| 1912288960 | Susan Winterhalter Decker | Physician Assistant | 6801 Brecksville Rd Ste 10, Independence, OH 44131-5057 | 2011-09-05 |
| 1730415597 | Emily M Hennes | Physician Assistant | 19550 E 39th St S, Ste 410, Independence, MO 64057-2303 | 2009-10-28 |
| 1205075249 | Tangipahoa Emergency Group LLC | Physician Assistant | 52579 Highway 51 S, Independence, LA 70443-2231 | 2009-02-16 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 64050 |
Please comment or provide details below to improve the information on MR. PHILLIP SCOTT GILLIAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.