GARY GILLIAM (FNP) – Family Nurse Practitioner, NPI 1154704708

GARY GILLIAM (FNP) is a healthcare provider. based in Dungannon, Virginia. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 0024172696 (VA). The NPI Number for GARY GILLIAM (FNP) is 1154704708

Main info

Male
11 Years Of Experience
Name
GARY GILLIAM (FNP)
NPI
1154704708
Phone
(276) 467-2201
Address
17285 VETERANS MEMORIAL HWY
Enumeration Date
1 July 2015
Last Update Date
8 November 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2764672201
Graduation Year
2015 (11 years ago)
PAC ID
2365757879
Group Practice PAC ID
6709835002
Professional Enrollment ID
I20150812008860
Address ID
VA242453937DU17285HWYX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

8,303 NURSE PRACTITIONER in VA

Provider Addresses for GARY GILLIAM (FNP)

  • 17285 VETERANS MEMORIAL HWY

    DUNGANNON, VA 242453937

    Phone: (276) 467-2201

    Fax: (276) 467-2673

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $274.

Total Amount is formed as General ($274) + Research ($0) + Ownership ($0) = $274.

Last reported payment date: 2024-11-05 • Largest payer in this snapshot: Lilly USA, LLC ($77).

Total Amount

$274

General + Research + Ownership

Payments

16

Total payment records

General Amount

$274

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-05

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2015-08-12

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150812008860INurse PractitionerVATBD

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.

Verify on CMS Revalidation Lookup Tool

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 24245)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709835002View full group profile
NameSpecialtyState
Nurse PractitionerVA
-VA
-VA
Nurse PractitionerVA
Nurse PractitionerVA
Nurse PractitionerVA
Nurse PractitionerVA
Nurse PractitionerTN
Clinical Social WorkerVA
Clinical Social WorkerVA

Reviews

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Frequently asked questions

How do I look up GARY GILLIAM (FNP) by NPI?
Use NPI 1154704708 when you need to reference GARY GILLIAM (FNP) in forms, claims, or directories.
Is GARY GILLIAM (FNP) active in the national directory?
GARY GILLIAM (FNP)'s public NPI profile is in an active state.
What field does GARY GILLIAM (FNP) work in?
You can think of GARY GILLIAM (FNP) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for GARY GILLIAM (FNP)?
The page summarizes Dungannon, Virginia for GARY GILLIAM (FNP); expand the address list for detail.
How can I contact GARY GILLIAM (FNP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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