Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

THARA L GUILLORY
NPI 1083581490
Nurse Practitioner - Gerontology in Avenel, NJ

Q: What is Thara Guillory's NPI number?

The NPI number for Thara Guillory is 1083581490. It was assigned to this individual provider in the NPPES registry on October 21, 2025.

Q: What is Thara Guillory's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Thara Guillory was last updated on August 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 21, 2025PECOS Enrolled

1300 STATION DR APT 1303, AVENEL, NJ 07001(386) 868-9658 Get Directions Write a Review

NPPES record last updated: August 25, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Thara L Guillory NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THARA L GUILLORY (NPI 1083581490) is an individual gerontology provider in Avenel, New Jersey, licensed in New Jersey (26NJ15465900) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1083581490

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameTHARA L GUILLORY

Location Address1300 STATION DR APT 1303Avenel, NJ 07001-1869

Mailing Address1300 Station Dr Apt 1303Avenel, NJ 07001-1869 · (386) 868-9658

Phone(386) 868-9658

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateOctober 21, 2025

Last NPPES UpdateAugust 25, 2026

NPPES CertifiedAugust 25, 2026

✔ NPI 1083581490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in NJ · 26NJ15465900

Also ListedRegistered Nurse · Registered Nurse First AssistantTaxonomy 163WR0006X · License RN9573108 (FL)

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License N10571 (NY), RN9573108 (FL)

1300 STATION DR APT 1303, Avenel, NJ 07001

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Thara L Guillory is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951874205

PECOS Enrollment IDI20260626004190

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thara Guillory's NPI number?

The NPI number for Thara Guillory is 1083581490. It was assigned to this individual provider in the NPPES registry on October 21, 2025.

Where is Thara Guillory located?

Thara Guillory practices at 1300 Station Dr Apt 1303, Avenel, NJ 07001. The listed phone number is (386) 868-9658.

What is Thara Guillory's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Thara Guillory enrolled in Medicare?

Yes. Thara Guillory is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Thara Guillory was last updated on August 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.