Active NPI
Gabriel J Redmond, PT
- Physical Therapist
- South Portland, ME
National Provider Identifier
1104826932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT2517
- Practice address
- 29 Foden Rd
South Portland, ME 04106-1706 - Phone
- (207) 772-2625
- Fax
- (207) 879-4246
- NPI assigned
- Jul 22, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT2517 | ME | Primary |
Addresses
Primary practice location
29 Foden Rd
South Portland, ME 04106-1706
Mailing address
29 Foden Rd
South Portland, ME 04106-1706
Phone (207) 772-2625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 027896 | Other | ME | BC/BS OF MAINE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT2517 | ME | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364169600000",
"number": "1104826932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 FODEN RD",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041061706",
"telephone_number": "207-772-2625",
"fax_number": "207-879-4246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 FODEN RD",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041061706",
"telephone_number": "207-772-2625",
"fax_number": "207-879-4246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDMOND",
"first_name": "GABRIEL",
"middle_name": "J",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-22",
"last_updated": "2013-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT2517",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF MAINE",
"identifier": "027896",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.