Chandler Gentz, DPT
Individual provider Active NPI Physical Therapist · Jasper, AL
NPI 1003560764 · NPPES record last updated Feb 10, 2022
Key facts
- NPI
- 1003560764
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PTH10723 (AL)
- Practice address
- 200 N Airport Rd Ste 110
Jasper, AL 35504-7676 - Phone
- (205) 387-3267
- NPI assigned
- Feb 10, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Therapy South Jasper LLC
Practice addresses (Care Compare)
200 N Airport Rd
Suite 110
Jasper, AL 35504-7521
Phone (205) 387-3266
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220228000670 | AL | Practitioner - Physical Therapist in Private Practice | 3779977293 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTH10723 | AL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy South Cullman LLC | Physical Therapist | Current |
Accepting new patients |
| Therapy South Jasper LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1208 Cullman Shopping Ctr NW
Cullman, AL 35055
Phone (256) 775-4456
2823 Greystone Commercial Blvd
Hoover, AL 35242
Phone (205) 408-1713
200 N Airport Rd
Ste 110
Jasper, AL 35504
Phone (205) 387-3266
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH10723 | AL | Yes |
Addresses
Primary practice location
200 N Airport Rd Ste 110
Jasper, AL 35504-7676
Mailing address
2823 Greystone Commercial Blvd
Hoover, AL 35242-2660
Other providers in Jasper, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.