Gretchen Sophia Prout

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05013399A Issued in IN

Practice address

6239 S East St Ste a
Indianapolis, IN 46227-2088

Phone

(317) 791-9031

Fax

(317) 791-9001

NPI assigned

Aug 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Pediplay LLC

  • Occupational Therapist
  • Indianapolis, IN
  • NPI 1679695381
  NPD (past)

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1326695883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6239 S EAST ST STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272088",
            "telephone_number": "317-791-9031",
            "fax_number": "317-791-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6239 S EAST ST STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272088",
            "telephone_number": "317-791-9031",
            "fax_number": "317-791-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUT",
        "first_name": "GRETCHEN",
        "middle_name": "SOPHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013399A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth P Prosser, MD
• Prosthetic Technologies LLC
• Proteam Tactical Performance
• Protected Provision Homecare LLC
• Stella Protopapas, MD, MPH
• John William Prout III, PHARMD
• Elizabeth J Proven, M.A., CCC-SLP
• Mary Anita Provence, LCSW
• Christian Provenza
• Providence Medical Associates LLC

• Physical Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.