Active NPI
Drew Gunnell, PTA
- Physical Therapy Assistant
- Danville, VA
National Provider Identifier
1215530951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2306604786
- Practice address
- 109 Bridge St Ste 300
Danville, VA 24541-1222 - Phone
- (434) 793-4711
- Fax
- (434) 797-2514
- NPI assigned
- Nov 17, 2020
- 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 Therapy Assistant | 225200000X | 2306604786 | VA | Primary |
Addresses
Primary practice location
109 Bridge St Ste 300
Danville, VA 24541-1222
Mailing address
109 Bridge St Ste 300
Danville, VA 24541-1222
Phone (434) 793-4711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2306604786 | Other | VA | VA STATE LICENSE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.spectrummed.com | ||
| CONNECT URL | www.spectrummed.com | Direct |
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 |
|---|---|---|---|
| 2306604786 | VA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1215530951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 BRIDGE ST STE 300",
"city": "DANVILLE",
"state": "VA",
"postal_code": "245411222",
"telephone_number": "434-793-4711",
"fax_number": "434-797-2514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 BRIDGE ST STE 300",
"city": "DANVILLE",
"state": "VA",
"postal_code": "245411222",
"telephone_number": "434-793-4711",
"fax_number": "434-797-2514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNNELL",
"first_name": "DREW",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-17",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2306604786",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA STATE LICENSE",
"identifier": "2306604786",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.spectrummed.com",
"affiliation": "N",
"address_1": "109 Bridge St Ste 300",
"city": "Danville",
"state": "VA",
"country_code": "US",
"postal_code": "245411222",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.spectrummed.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "109 Bridge St Ste 300",
"city": "Danville",
"state": "VA",
"country_code": "US",
"postal_code": "245411222",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Danville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.