JACOB R GILLEN (NPI# 1952625576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952625576 |
| Entity Type | Individual |
| Full Name | JACOB R GILLEN |
| Credential | MD |
| Practice Address |
1906 Belleview Ave Se Roanoke VA 24014 |
| Mailing Address |
1906 Belleview Ave Se Roanoke VA 24014-1838 |
| Practice Telephone | 5409817000 |
| Practice Fax Number | 5409818429 |
| Mailing Telephone | 5409817000 |
| Mailing Fax Number | 5409818429 |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2018-09-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
0101264407 | VA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 4301109915 | MI | Student, Health Care |
| Street Address |
1906 BELLEVIEW AVE SE |
| City | ROANOKE |
| State | VA |
| Zip Code | 24014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053315796 | Lee Ann Speed | Registered Nurse | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2005-06-10 |
| 1114526605 | Kimberly Ann Ramsey | Clinical Nurse Specialist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-10-26 |
| 1578181285 | Sarah Lipps | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-09 |
| 1124646831 | Shannon Victoria Brown | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-09 |
| 1285252189 | Yang Zhao | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1932727831 | Jonathan Zalman | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1669090569 | Miranda Thomas | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1427676329 | Zachary Seth Stevenson | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1053939801 | Narmada Mannem | Student in an Organized Health Care Education/Training Program | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1821616657 | Vanessa Pellegrino | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558602 | Irene Pace Seidman | Pharmacist | 3350 Clearbrook Village Ln, Roanoke, VA 24014 | 2020-11-04 |
| 1720617970 | Mounica Reddy Thootkur | Student in an Organized Health Care Education/Training Program | 2017 South Jefferson Street, 2nd Floor, Roanoke, VA 24014 | 2020-04-08 |
| 1326675422 | Bharath Muppala | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2020-03-26 |
| 1235629239 | Sanjeeb Sudarshan Bhandari | Student in an Organized Health Care Education/Training Program | 1906 Bellview Ave Se, Roanoke, VA 24014 | 2018-05-15 |
| 1104325778 | Vera J. Short | Registered Nurse | 3167 Huffman Ln, Roanoke, VA 24014 | 2018-02-08 |
| 1770001380 | Michael Alan Phillips I | Social Worker | 2017 Jefferson Street, Roanoke, VA 24014 | 2017-09-03 |
| 1306362884 | Sara Alicia Guasch | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2017-08-16 |
| 1790212256 | Pouya Mafi | Student in an Organized Health Care Education/Training Program | 1906 Belleview Ave, Carilion Roanoke Memorial Hospital, Roanoke, VA 24014 | 2017-05-16 |
| 1790222867 | Mara Cate | Physician Assistant | 523 Arbuttus Ave, Roanoke, VA 24014 | 2017-01-26 |
| 1508314634 | Dknl Enterprises, Inc. | Non-emergency Medical Transport (VAN) | 3629 Franklin Rd Sw Suite 205b, Roanoke, VA 24014 | 2016-09-19 |
| Find all providers in zip 24014 | ||||
| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457551707 | Katie Love Bower | Surgery | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500754 | Juan Carlos Torres | Surgery | 4100 David Ln, Alexandria, VA 22311-1113 | 2020-08-29 |
| 1770132409 | Hiba Ezzeddine | Surgery | Vcuhs Dept of Acute Care Surgery Fellowship, 980454, 1250 E. Marshall Street, Richmond, VA 23298-0454 | 2019-09-05 |
| 1669943890 | Taylor Erin D'etcheverry | Surgery | 20560 Southport Landing Pl, Smithfield, VA 23430-8116 | 2018-12-16 |
| 1780997080 | Dustin Donley | Surgery | 7101 Jahnke Rd Bldg Suite260, Richmond, VA 23225-4017 | 2010-07-15 |
| 1417936493 | Joseph Charles Babrowicz Jr. | Surgery | 3299 Woodburn Rd Ste 230, Annandale, VA 22003-7319 | 2006-01-10 |
| 1114366028 | Charles Kevin Grigsby | Surgery | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1912 | 2013-06-25 |
| 1831487479 | Asanthi Marian Ratnasekera | Surgery | 1250 E Marshall St, Pob 980257, Richmond, VA 23298-0257 | 2011-07-18 |
| 1255621900 | Michael T Martyak | Surgery | 825 Fairfax Ave Ste 610, Norfolk, VA 23507-1914 | 2011-04-14 |
| 1104116235 | John Patrick Davis | Surgery | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2011-04-11 |
| 1609019314 | Jessica Robin Burgess | Surgery | 825 Fairfax Ave, Suite 610, Norfolk, VA 23507-1914 | 2009-04-10 |
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| 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.