MRS. KELLEY SUSAN GILLIS PA-C NPI 1265533137

NPI Information

NPI: 1265533137
Provider Name: MRS. KELLEY SUSAN GILLIS, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: DARTMOUTH HITCHCOCK CLINIC

PECOS Registration: Yes

Address:
2300 SOUTHWOOD DR
DARTMOUTH HITCHCOCK - URGENT CARE
NASHUA, NH
ZIP 03063
Phone: (603) 577-4188
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MRS. Kelley Susan Gillis, PA-C is a medical physician assistant in Nashua, NH with 21 years of experience. MRS. Kelley Susan Gillis, PA-C NPI is 1265533137. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2300 SOUTHWOOD DR
DARTMOUTH HITCHCOCK - URGENT CARE
NASHUA, NH
ZIP 03063-818
Phone: (603) 577-4188

The NPI 1265533137 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/25/2006 and was last updated on 7/5/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	0525	NEW HAMPSHIRE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	Q68271	MEDICARE UPIN	NEW HAMPSHIRE
2	AP2624	MEDICARE ID-TYPE UNSPECIFIED	NEW HAMPSHIRE
3	30334240	MEDICAID	NEW HAMPSHIRE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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