Kim L Gates, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT001641 Issued in GA

Practice address

2155 W Park CT
Suite G/ H
Stone Mountain, GA 30087-3500

Phone

(770) 465-5084

Fax

(770) 465-5304

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pruitthealth Therapy Services, Inc.

  • Rehabilitation Clinic/Center
  • Norcross, GA
  • NPI 1013152933

  Physical Therapist

  Medicare reassignment NPD
• Sierra Therapy Services, Inc.

  • Physical Therapist
  • Stone Mountain, GA
  • NPI 1083643449
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013006279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 W PARK CT",
            "address_2": "SUITE G/ H",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873500",
            "telephone_number": "770-465-5084",
            "fax_number": "770-465-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 W PARK CT",
            "address_2": "SUITE G/ H",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873500",
            "telephone_number": "770-465-5084",
            "fax_number": "770-465-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "KIM",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT001641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gamble Dentalsmart, PC
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• Brandy Gatlin
• Carmella Andrea Gayle
• Ronda F Gedward, EDD
• Genematrix Laboratory LLC

• Physical Therapist in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.