MR. BRENT DOUGLASS GILLESPIE (NPI# 1285153346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285153346 |
| Entity Type | Individual |
| Full Name | MR. BRENT DOUGLASS GILLESPIE |
| Credential | MSPAS |
| Practice Address |
3401 4th St Nw Albuquerque NM 87107-2423 |
| Mailing Address |
933 Bradbury Dr Se Ste 1134 Albuquerque NM 87106-4375 |
| Practice Telephone | 5059945300 |
| Mailing Telephone | 5059945300 |
| Mailing Fax Number | 5053441233 |
| Enumeration Date | 2017-09-10 |
| Last Update Date | 2017-09-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA2017-0067 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3401 4TH ST NW |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87107-2423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649472499 | Kathy Z. Chang | Family Medicine | 3401 4th St Nw, Albuquerque, NM 87107-2423 | 2007-06-04 |
| 1023649449 | Kaeli Vandersluis | Family Medicine | 3401 4th St Nw, Albuquerque, NM 87107-2423 | 2020-02-04 |
| 1871152603 | Wanni Zhou | Psychologist | 3401 4th St Nw, Albuquerque, NM 87107-2423 | 2019-06-05 |
| 1942734116 | Lisa Ann Lintzenich | Nurse Practitioner | 3401 4th St Nw, Albuquerque, NM 87107-2423 | 2017-04-14 |
| 1255714101 | Unm Hospital | Pharmacy | 3401 4th St Nw, Ste 106, Albuquerque, NM 87107-2423 | 2015-07-09 |
| 1619357225 | Jessica Johnston | Physician Assistant | 3401 4th St Nw, Albuquerque, NM 87107-2423 | 2015-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589785 | Benjamin Argant | Behavior Technician | 331 Candelaria Road North East Suite A, Albuquerque, NM 87107 | 2020-08-20 |
| 1679138861 | Susan Luna, Lpcc LLC | Counselor | 3221 B Candelaria Ne, Albuquerque, NM 87107 | 2019-05-03 |
| 1407310881 | Eleanor Cloe Tibbetts | Speech-Language Pathologist | 7103 4th St. Nw Chatterbox Speech Therapy, Los Ranchos, NM 87107 | 2019-01-30 |
| 1386174829 | Triple D Medical Transportation, LLC. | Secured Medical Transport (VAN) | 2123 Menaul Blvd Ne Ste B, Albuquerque, NM 87107 | 2017-06-18 |
| 1487100715 | Kayleen Weinandt | Community/Behavioral Health | 3301 Los Arboles Ne, Albuquerque, NM 87107 | 2016-08-28 |
| 1811345549 | Inverse Medical, LLC | Non-emergency Medical Transport (VAN) | 1015 Cottonwood Dr. Suite J, Albuquerque, NM 87107 | 2016-06-03 |
| 1710349220 | Evolv Strong, LLC | Specialist/Technologist | 3201 Candelaria Rd Ne, Albuquerque, NM 87107 | 2016-03-23 |
| 1982072443 | Erik Robinson | Social Worker | 7801 Academy Road, Ne 2-200, Albueruque, NM 87107 | 2015-09-14 |
| 1033505763 | Sam Newmon Ma, Lpcc | Counselor | 320-h Osuna Rd Ne, Suite 4, Albuquerque, NM 87107 | 2015-04-09 |
| 1760896203 | Jocelyn Fiaschetti | Social Worker | 7704 4th Street Nw, Albuquerque, NM 87107 | 2014-06-12 |
| Find all providers in zip 87107 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474550 | Mara Swartzentruber | Physician Assistant | 3310 Linda Vista Ave Se, Albuquerque, NM 87106-1514 | 2020-10-13 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1487287413 | Thomas Clise | Physician Assistant | 629 San Pablo St Ne, Albuquerque, NM 87108-2137 | 2020-02-18 |
| 1912547324 | Kathleen Joyce L'heureux | Physician Assistant | 8124 Ventana Cielo Ave Nw, Albuquerque, NM 87114-5988 | 2020-01-14 |
| 1265097869 | Amber Zoubovitch | Physician Assistant | 7200 Montgomery Blvd Ne Ste 7121, Albuquerque, NM 87109-1510 | 2019-05-08 |
| 1639680739 | Wesley A Parker | Physician Assistant | 3777 Mdg, 2050a Second Street Se, Albuquerque, NM 87117-5522 | 2017-10-16 |
| 1003327487 | Elise Nicole Pedigo | Physician Assistant | 4700 Jefferson St Ne Ste 700, Albuquerque, NM 87109-2132 | 2017-10-12 |
| 1194170605 | Anna Marie Siow | Physician Assistant | 1014 Hummingbird Pl Sw, Albuquerque, NM 87105-8130 | 2016-05-03 |
| 1285032367 | Travis Householder | Physician Assistant | 201 Cedar St Se Ste 4610, Presbyterian Heart Group, Albuquerque, NM 87106-4936 | 2014-12-05 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.