Gabrielle Lynn Pulliam, DPT
Individual provider Active NPI Physical Therapist · Clarksville, IN
NPI 1174987366 · NPPES record last updated Sep 12, 2022
Key facts
- NPI
- 1174987366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 05014594A (IN)
- Practice address
- 325 E Lewis and Clark Pkwy
Clarksville, IN 47129-1725 - Phone
- (812) 283-3231
- Fax
- (812) 283-3271
- NPI assigned
- Apr 13, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Harvest Health and Rehab LLC
SN Kentuckiana Rehab, LLC
Practice addresses (Care Compare)
300 E Broadway St
Loogootee, IN 47553-1708
Phone (812) 709-3286
325 E Lewis and Clark Pkwy
Suite 100
Clarksville, IN 47129-1725
Phone (812) 283-3231
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220427001601 | IN | Practitioner - Physical Therapist in Private Practice | 1850626383 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05014594A | IN | MD | Physical Therapist |
| 4773 | NM | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SN Kentuckiana Rehab, LLC | Current |
Accepting new patients | |
| SN Kentuckiana Rehab, LLC | Current |
Accepting new patients | |
| Harvest Health & Rehab LLC | Physical Therapist | Current |
Accepting new patients |
| SN Kentuckiana Rehab, LLC | Past | Accepting new patients | |
| SN Kentuckiana Rehab, LLC | Past | Accepting new patients | |
| SN Kentuckiana Rehab, LLC | Physical Therapist | Past | Accepting new patients |
| SN Kentuckiana Rehab, LLC | Past | Accepting new patients | |
| SN Kentuckiana Rehab, LLC | Past | Accepting new patients |
Locations
9407 County Road 403
Charlestown, IN 47111
Phone (812) 256-0528
325 E Lewis and Clark Pkwy
Ste 100
Clarksville, IN 47129
Phone (812) 283-3231
173 Pacer Dr NW
Corydon, IN 47112
Phone (502) 964-5404
1050 Copperfield Dr
Georgetown, IN 47122
Phone (812) 651-1440
3451 E 10th St
Jeffersonville, IN 47130
Phone (812) 218-8039
1730 Williamsburg Dr
Ste 3
Jeffersonvlle, IN 47130
Phone (812) 246-0705
3154 E 10TH St
Jeffersonvlle, IN 47130
3626 Grant Line Rd
Ste 105
New Albany, IN 47150
Phone (502) 558-2903
651 Hamburg Way
Ste 300
Sellersburg, IN 47172
Phone (812) 248-8180
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4773 | NM | |
| Physical Therapist | 225100000X | PTP-PT-LIC-17045 | MT | |
| Physical Therapist | 225100000X | 05014594A | IN | Yes |
Addresses
Primary practice location
325 E Lewis and Clark Pkwy
Clarksville, IN 47129-1725
Mailing address
325 E Lewis and Clark Pkwy
Clarksville, IN 47129-1725
Phone (812) 283-3231
Other practice location 1
105 Village Loop Rd Ste A
Kalispell, MT 59901
Phone (406) 756-7878
Other practice location 2
2211 Main Street NE
Suite C
Los Lunas, NM 87031
Phone (505) 866-1677 ext. 3130
Other providers in Clarksville, IN
- Edna B Pretila
- Kaitlyn Price
- Heather L Proffitt
- Prorehab Louisville, LLC
- Megan Elizabeth Psiones
- Mark Pulliam
- Pulmonary & Critical Care Consultants of Louisville
- Caitlin Michelle Rager
- Rukhsana Ikram Rahman
- Tresa V Ratterman
All providers in Clarksville, IN · Physical Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 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.