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Jeremy Thomas Gillespie

Internal Medicine

Allopathic & Osteopathic Physicians

195 Kimel Park Dr Ste 200, Winston Salem, NC 27103-6967

PECOS Enrollment

This provider is enrolled in PECOS as JEREMY GILLESPIE.

Based on the most recent information from CMS, provider Jeremy Thomas Gillespie is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1407146319
Provider Type
Individual
Full Name
Gillespie, Jeremy Thomas
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
4/12/2011
Last Updated
8/7/2024

Contact Information

Practice Location

195 Kimel Park Dr Ste 200, Winston Salem, NC 27103-6967

(336) 768-6211

Unlisted Fax

Mailing Location

195 Kimel Park Dr Ste 200, Winston Salem, NC 27103-6967

(336) 768-6211

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 2021-00899 North Carolina
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 036134921 Illinois
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 036134921 Illinois

Jeremy Thomas Gillespie

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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