Brad D Gillette, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT24056 Issued in FL

Practice address

1719 1St St N
Jacksonville Beach, FL 32250-7411

Phone

(208) 860-8099

NPI assigned

Jun 25, 2008

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1124280755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 1ST ST N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322507411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 1ST ST N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322507411",
            "telephone_number": "208-860-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "BRAD",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT24056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Lane Ghandour, PA-C, DHSC
• Laura Ghasseminia
• Francisco Jose Gil, PA
• Samuel Giles
• Danielle Amanda Gill, SLP
• Matthew L Glass, D.C
• Austin Glennon, DC, BS
• Jaime Goguen, DC
• Joshua Leo Goldknopf, D.D.S.
• Kristin Lee Gonzalez, DNP

• Physical Therapist in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.