Vince A Gildner Jr., PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

602183250 Issued in WA

Practice address

111 Tumwater Blvd SE
Suite 113
Tumwater, WA 98501-6400

Phone

(360) 528-3300

Fax

(360) 528-8162

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pro-Active Sportsmed PLLCGroup PAC ID 2062303969, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pro-Active Sportsmed PLLC

  • Orthopedic Physical Therapist
  • Tumwater, WA
  • NPI 1861612335
  Medicare reassignment Care Compare group NPD Authorized official
• North Peninsula Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Poulsbo, WA
  • NPI 1447718556
  Medicare reassignment NPD
• En Pointe Physical Therapy, PLLC

  • Orthopedic Physical Therapist
  • Redmond, WA
  • NPI 1467967737
  NPD (past)
• Next Level Physical Therapy and Performance Inc.

  • Physical Therapist
  • Scottsdale, AZ
  • NPI 1881061257
  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1396746418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TUMWATER BLVD SE",
            "address_2": "SUITE 113",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985016400",
            "telephone_number": "360-528-3300",
            "fax_number": "360-528-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 TUMWATER BLVD SE",
            "address_2": "SUITE 113",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985016400",
            "telephone_number": "360-528-3300",
            "fax_number": "360-528-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDNER",
        "first_name": "VINCE",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "602183250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I INDIVIDUAL",
            "identifier": "158090",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8406068",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE INDIVIDUAL",
            "identifier": "8610GI",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary German, O.D.
• Andrew G. Giannotti, MD
• Samantha Gibb, MSW
• Pandy Beth Gibson
• William C Gierach, LAT
• Anoop Kaur Gill, DDS
• Elizabeth Asuncion Gill
• Stacey L Gill
• Douglas Ginter, BSN, RN-BC, MHP
• Genevieve Y Girdner, A.T.C.

• Physical Therapist in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.