CHARLSIE FERGUSON GILLCOAT (ACNP-BC) – Primary Care Nurse Practitioner, NPI 1629246574
Primary Care Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for CHARLSIE FERGUSON GILLCOAT (ACNP-BC)
Band Box Place, Dallas, Dallas County, Texas, 75244, United States
DALLAS, TX 753911230
Phone: (972) 997-8000
Fax: (972) 234-0813
Type: Mailing
1300 N 4TH ST
LONGVIEW, TX 756014717
Phone: (903) 757-2122
Fax: (903) 757-9475
Type: Location
707 HOLLYBROOK DR STE 200
LONGVIEW, TX 756052410
Phone: (903) 291-6191
Type: Mailing
700 E MARSHALL AVE
LONGVIEW, TX 756015580
Phone: (903) 315-1488
Fax: (903) 315-1696
Type: Location
2221 H G MOSLEY PKWY STE 101
LONGVIEW, TX 756043670
Phone: (903) 903-0903
Fax: (903) 765-4437
Type: Location
2828 4TH ST STE 100
LONGVIEW, TX 756055712
Phone: (903) 903-0903
Fax: (903) 765-4437
Type: Mailing
2828 4TH ST # 100
LONGVIEW, TX 756055718
Phone: (903) 903-0903
Fax: (903) 213-9045
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 57 Open Payments records for all available years, with a total value of $1,425.
Total Amount is formed as General ($1,425) + Research ($0) + Ownership ($0) = $1,425.
Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Lilly USA, LLC ($237).
Total Amount
$1,425
General + Research + Ownership
Payments
57
Total payment records
General Amount
$1,425
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $237 |
| Bayer Healthcare Pharmaceuticals Inc. | $173 |
| Abbott Laboratories | $143 |
| Inspire Medical Systems, Inc. | $136 |
| ABBVIE INC. | $133 |
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: 2008-06-04
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 |
|---|---|---|---|---|
| I20080604000591 | I | Nurse Practitioner | 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 75391)
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