CASSANDRA SHEA GILLIAM PMHNP-BC NPI 1639652829

NPI Information

  • NPI: 1639652829
  • Provider Name: CASSANDRA SHEA GILLIAM, PMHNP-BC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 135 MACON WEST DR
    MACON, GA
    ZIP 31210
  • Phone: (478) 496-4896

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NPI Details

Cassandra Shea Gilliam, PMHNP-BC is a psychiatric/mental health nurse practitioner in Macon, GA with 4 years of experience. Cassandra Shea Gilliam, PMHNP-BC NPI is 1639652829. 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:

135 MACON WEST DR
MACON, GA
ZIP 31210-652
Phone: (478) 496-4896
Fax: (478) 389-0204

The NPI 1639652829 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 9/13/2018 and was last updated on 12/9/2025.

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
1363LP0808XNurse PractitionerPsychiatric/Mental Health53-84213-062KANSASNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN11037013FLORIDANo
3363LP0808XNurse PractitionerPsychiatric/Mental Health14205407-4405UTAHNo
4363LP0808XNurse PractitionerPsychiatric/Mental HealthAP61651272WASHINGTONNo
5363LP0808XNurse PractitionerPsychiatric/Mental HealthRN171251GEORGIAYes

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: 11/21/2025

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