Gentle Sticks on Wheels

Primary specialty

TechnicianTaxonomy code 374700000X

Legal business name

GENTLE STICKS ON WHEELS

Practice address

1829 Forest Glen Dr
Fruitland Park, FL 34731-6565

Phone

(352) 431-1193

NPI assigned

Jul 29, 2021

Last updated

Sep 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alysha PettisNPI 1942884846

Title

Owner

Phone

(352) 431-1193

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alysha Pettis

  • Pathology Technician
  • Fruitland Park, FL
  • NPI 1942884846

  Technician, Pathology

  NPD Authorized official

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631491200000",
    "number": "1184397713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 FOREST GLEN DR",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347316565",
            "telephone_number": "352-431-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 FOREST GLEN DR",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347316565",
            "telephone_number": "352-431-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENTLE STICKS ON WHEELS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A",
        "authorized_official_last_name": "PETTIS",
        "authorized_official_first_name": "ALYSHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-431-1193"
    },
    "taxonomies": [
        {
            "code": "246R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942884846",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig D Fishman, M.D.
• Fivestar Medical Supplies, LLC
• Tina Marie Flannery
• Florida Hospital Waterman Inc (Adventhealth Fruitland Park ER)
• Alyssa M Forst
• Amy Giddens, OT/L
• Marquisa Denise Gillard
• Claudia Gonzalez
• Lauren Gordon
• Rachael Graham, RDN, LDN

• Technician in Fruitland Park, FL
• Providers in Fruitland Park, FL by specialty
• Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.