Individual provider Active NPI

Tracy Elizabeth Gannon, MSPT

  • Physical Therapist
  • East Greenwich, RI
National Provider Identifier
1295046282
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT01111 Issued in RI
Practice address
5600 Post Road
Suite 116
East Greenwich, RI 02818
Phone
(401) 885-0069
Fax
(401) 885-0071
NPI assigned
Jun 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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 PT01111 RI Primary

Addresses

Primary practice location

5600 Post Road
Suite 116
East Greenwich, RI 02818

Mailing address

100 Hartshorn Road
Providence, RI 02906
Phone (401) 885-0069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101103000563 RI Practitioner - Physical Therapist in Private Practice 5496949422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedics Rhode Island IncGroup PAC ID 7012225907, 123 clinicians

Practice addresses (Care Compare)

1 High St
Wakefield, RI 02879-3103
Phone (401) 777-7000

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT01111RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedics Rhode Island, Inc Physical Therapist CurrentSince Oct 7, 2015 Accepting new patients
Orthopedics Rhode Island, Inc CurrentSince Oct 7, 2015 Accepting new patients
Contrology Physical Therapy, Inc Physical Therapist PastSince Aug 12, 2010 Accepting new patients
Alpha Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Contrology LLC Physical Therapist PastSince Nov 8, 2007 Accepting new patients

Locations

900 Warren Ave
Ste 202
East Providence, RI 02914

1 High St
Wakefield, RI 02879
Phone (401) 789-1422

300 Crossings Blvd
Warwick, RI 02886
Phone (716) 208-1708

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1295046282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HARTSHORN ROAD",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02906",
            "telephone_number": "401-885-0069",
            "fax_number": "401-885-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 POST ROAD",
            "address_2": "SUITE 116",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "02818",
            "telephone_number": "401-885-0069",
            "fax_number": "401-885-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "TRACY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenwich, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.

Verify at the official NPI Registry.