JACLYN P GILLIAM (CNM) – Advanced Practice Midwife, NPI 1154483113
Advanced Practice Midwife
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
200 CERTIFIED NURSE MIDWIFE (CNM) in TX
Provider Addresses for JACLYN P GILLIAM (CNM)
705 E Marshall Ave Ste 3000
Longview, TX 756015661
Phone: (903) 758-2610
Fax: (903) 758-7081
Type: Location
1107 E Marshall Ave
Longview, TX 756015602
Phone: (903) 758-2610
Fax: (903) 758-3124
Type: Location
802 Medical Dr Ste 101
Longview, TX 756055169
Phone: (903) 758-2610
Fax: (903) 758-7081
Type: Location
1761 W LOOP 281
LONGVIEW, TX 756042734
Phone: (903) 758-2610
Fax: (903) 758-7081
Type: Location
1107, East Marshall Avenue, Longview, Gregg County, Texas, 75601, United States
LONGVIEW, TX 756015602
Phone: (903) 675-8261
Fax: (903) 758-3124
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $383.
Total Amount is formed as General ($383) + Research ($0) + Ownership ($0) = $383.
Last reported payment date: 2024-10-01 • Largest payer in this snapshot: ABBVIE INC. ($120).
Total Amount
$383
General + Research + Ownership
Payments
7
Total payment records
General Amount
$383
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-01
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-10-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20071005000428 | I | Certified Nurse Midwife (Cnm) | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75601)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| - | TX | |
| Nurse Practitioner | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| Family Practice | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| Nurse Practitioner | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| Nurse Practitioner | TX |
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