Active NPI
Emily Margaret Gantt, PT, DPT, ATC
- Physical Therapist
- Vestavia, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH11025
- Practice address
- 3125 Blue Lake Dr
Vestavia, AL 35243-2333 - Phone
- (205) 969-7887
- NPI assigned
- Jan 3, 2018
- Last updated
- Aug 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH11025 | AL | Primary |
| Athletic Trainer | 2255A2300X | 2601002155 | MI |
Addresses
Primary practice location
3125 Blue Lake Dr
Vestavia, AL 35243-2333
Mailing address
3125 Blue Lake Dr
Vestavia, AL 35243-2333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL, MA
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 3Rd Ave S
Birmingham, AL 35233-2517
Phone (205) 202-6078
54 Harvard St
Brookline, MA 02445-7940
Phone (617) 262-0030
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTH11025 | AL | MD | Physical Therapist |
| 2601002155 | MI | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nova Physical Therapy and Wellness, LLC | Physical Therapist | Current | Accepting new patients |
| Agile Physical Therapy, LLC | Current | Accepting new patients | |
| Boston Sports Medicine Inc | Physical Therapist | Current | Accepting new patients |
Locations
2500 3rd Ave S
Birmingham, AL 35233
Phone (205) 202-6078
2821 2nd Ave S
Ste E
Birmingham, AL 35233
Phone (205) 202-6078
3125 Blue Lake Dr
Vestavia, AL 35243
Phone (205) 969-7887
62 Harvard St
Ste 1
Brookline, MA 02445
Phone (617) 262-0030
14 McGrath Hwy
Somerville, MA 02143
Phone (617) 623-4500
Interoperability endpoints
- https://api.platform.athenahealth.com/11813/brand/1/csg/1/fhir/r4
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.
-
- Orthopedic Physical Therapist
- Birmingham, AL
- NPI 1073285342
-
- Physical Therapist
- Allston, MA
- NPI 1245217546
-
- Physical Therapy Clinic/Center
- Vestavia, AL
- NPI 1154578524
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661472000000",
"number": "1285141044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3125 BLUE LAKE DR",
"city": "VESTAVIA",
"state": "AL",
"postal_code": "352432333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3125 BLUE LAKE DR",
"city": "VESTAVIA",
"state": "AL",
"postal_code": "352432333",
"telephone_number": "205-969-7887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANTT",
"first_name": "EMILY",
"middle_name": "MARGARET",
"credential": "PT, DPT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-03",
"last_updated": "2022-08-26",
"certification_date": "2022-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH11025",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2601002155",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vestavia, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.