Individual provider Active NPI

Gloria Gould Gunter, MPT, MED, PCS

  • Physical Therapist
  • Hailey, ID
National Provider Identifier
1275512246
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
RPT1204 Issued in ID
Practice address
113 E Bullion St
Suite C
Hailey, ID 83333-8770
Phone
(208) 720-3421
Fax
(208) 297-2680
NPI assigned
Jan 10, 2006
Last updated
Jan 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X RPT1204 ID Primary

Addresses

Primary practice location

113 E Bullion St
Suite C
Hailey, ID 83333-8770

Mailing address

PO Box 92
Hailey, ID 83333-0092
Phone (208) 720-3421

Other identifiers 3

IdentifierTypeStateIssuer
000010030447OtherBLUE SHIELD OF IDAHO
1275512246MedicaidID
T4868OtherBLUE CROSS OF IDAHO

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
RPT1204IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Physical Therapy Physical Therapist PastSince Jan 1, 2013 Accepting new patients
Physical Therapy Plus of Idaho PLLC Physical Therapist PastSince Jan 1, 2001 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1275512246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833330092",
            "telephone_number": "208-720-3421",
            "fax_number": "208-297-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E BULLION ST",
            "address_2": "SUITE C",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338770",
            "telephone_number": "208-720-3421",
            "fax_number": "208-297-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNTER",
        "first_name": "GLORIA",
        "middle_name": "GOULD",
        "name_prefix": "Mrs.",
        "credential": "MPT, MED, PCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "RPT1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010030447",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275512246",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "T4868",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hailey, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.