Active NPI
Caitlin Ann Gunnells, CTRS
- Recreation Therapist
- Philadelphia, PA
National Provider Identifier
1104190289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 55682
- Practice address
- 1930 S Broad St
Philadelphia, PA 19145-2328 - Phone
- (215) 339-4563
- NPI assigned
- Mar 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 55682 | PA | Primary |
Addresses
Primary practice location
1930 S Broad St
Philadelphia, PA 19145-2328
Mailing address
620A Wrensong Rd
Yardley, PA 19067-6326
Phone (724) 991-4521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55682 | PA | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331078400000",
"number": "1104190289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620A WRENSONG RD",
"city": "YARDLEY",
"state": "PA",
"postal_code": "190676326",
"telephone_number": "724-991-4521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 S BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191452328",
"telephone_number": "215-339-4563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNNELLS",
"first_name": "CAITLIN",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-07",
"last_updated": "2012-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "PA",
"license": "55682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.