Individual provider Active NPI

Jonathan E Gates, DPT

  • Physical Therapist
  • Jasper, AL
National Provider Identifier
1346733169
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
296366 Issued in CA
Practice address
2604 Heritage Dr
Jasper, AL 35504-9306
Phone
(205) 435-0884
NPI assigned
Jun 7, 2018
Last updated
Mar 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH8914 AL
Physical Therapist 225100000X PT5394 NM
Physical Therapist 225100000X 1305049 TX
Physical Therapist 225100000X 135715 AK
Physical Therapist 225100000X 296366 CA Primary

Addresses

Primary practice location

2604 Heritage Dr
Jasper, AL 35504-9306

Mailing address

2604 Heritage Dr
Jasper, AL 35504-9306
Phone (205) 435-0884

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220221001435 AK Practitioner - Physical Therapist in Private Practice 2860886660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freedom Physical Therapy and Sports Rehabilitation LLCGroup PAC ID 1658682802, 2 clinicians

Practice addresses (Care Compare)

6383 Kenai Spur Hwy
Kenai, AK 99611-8302
Phone (907) 335-1155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135715AKMDPhysical Therapist
PTH8914ALMDPhysical Therapist
296366CAMDPhysical Therapist
PT5394NMMDPhysical Therapist
1305049TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Physical Therapy & Sports Rehabilitation, LLC Physical Therapist CurrentSince Mar 21, 2022 Accepting new patients

Locations

6383 Kenai Spur Hwy
Kenai, AK 99611
Phone (907) 260-8488

6415 Kenai Spur Hwy
Kenai, AK 99611
Phone (907) 335-1155

8513 NE Hazel Dell Ave
Ste 102
Vancouver, WA 98665
Phone (800) 594-8043

Organizations & group practices 1

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": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1346733169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 HERITAGE DR",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355049306",
            "telephone_number": "205-435-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 HERITAGE DR",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355049306",
            "telephone_number": "205-435-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "JONATHAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-07",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH8914",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT5394",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1305049",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "135715",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.