Individual provider Active NPI

Flora Virginia Eleace Gatewood, DPT

  • Physical Therapist
  • Valdosta, GA
National Provider Identifier
1336754274
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2804 N Oak St Ste C
Valdosta, GA 31602-5913
Phone
(229) 241-8925
NPI assigned
Sep 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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 Primary

Addresses

Primary practice location

2804 N Oak St Ste C
Valdosta, GA 31602-5913

Mailing address

2804 N Oak St Ste C
Valdosta, GA 31602-5913

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006002950 GA Practitioner - Physical Therapist in Private Practice 7911326202 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Thrive Physical Therapy and Wellness LLCGroup PAC ID 8123401379, 2 clinicians
Care Medical Center LLCGroup PAC ID 6406807015, 28 clinicians

Practice addresses (Care Compare)

111 Woodrow Wilson Dr
Suite C
Valdosta, GA 31602-2583
Phone (870) 732-4084

2804 N Oak St
Suite C
Valdosta, GA 31602-5913
Phone (229) 241-8925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Care Medical Center LLC CurrentSince Sep 23, 2020 Accepting new patients
Care Medical Center LLC CurrentSince Sep 23, 2020 Accepting new patients

Locations

310 Shirley Ave
Douglas, GA 31533
Phone (912) 260-3650

203 W Hamilton Ave
Nashville, GA 31639
Phone (229) 686-2277

162 Virginia Ave S
Tifton, GA 31794
Phone (229) 241-8925

2804 N Oak St
Ste C
Valdosta, GA 31602
Phone (229) 241-8925

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1336754274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 N OAK ST STE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 N OAK ST STE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025913",
            "telephone_number": "229-241-8925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATEWOOD",
        "first_name": "FLORA",
        "middle_name": "VIRGINIA ELEACE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.