Active NPI
Kayla Gauthier, PT, DPT
- Physical Therapist
- Marinette, WI
National Provider Identifier
1386043396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12667-24
- Practice address
- 3117 Shore Drive Suite 101
Bay Area Mobility Center
Marinette, WI 54143 - Phone
- (715) 732-5111
- NPI assigned
- Aug 14, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12667-24 | WI | Primary |
Addresses
Primary practice location
3117 Shore Drive Suite 101
Bay Area Mobility Center
Marinette, WI 54143
Mailing address
3117 Shore Drive Suite 101
Bay Area Mobility Center
Marinette, WI 54143
Phone (715) 732-5111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12667-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1386043396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3117 SHORE DRIVE SUITE 101",
"address_2": "BAY AREA MOBILITY CENTER",
"city": "MARINETTE",
"state": "WI",
"postal_code": "54143",
"telephone_number": "715-732-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3117 SHORE DRIVE SUITE 101",
"address_2": "BAY AREA MOBILITY CENTER",
"city": "MARINETTE",
"state": "WI",
"postal_code": "54143",
"telephone_number": "715-732-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUTHIER",
"first_name": "KAYLA",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-14",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12667-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marinette, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.