Active NPI
Brandi Gaspard, PTA
- Physical Therapy Assistant
- Conway, AR
National Provider Identifier
1417520503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4591
- Practice address
- 2425 Dave Ward Dr Ste 103
Conway, AR 72034-8679 - Phone
- (501) 327-1730
- NPI assigned
- Jul 19, 2021
- 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 Therapy Assistant | 225200000X | 4591 | Primary |
Addresses
Primary practice location
2425 Dave Ward Dr Ste 103
Conway, AR 72034-8679
Mailing address
2425 Dave Ward Dr Ste 103
Conway, AR 72034-8679
Phone (501) 327-1730
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTA4591 | Other | PHYSICAL THERAPIST ASSISTANT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | bgaspard@selectmedical.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626652800000",
"number": "1417520503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 DAVE WARD DR STE 103",
"city": "CONWAY",
"state": "AR",
"postal_code": "720348679",
"telephone_number": "501-327-1730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 DAVE WARD DR STE 103",
"city": "CONWAY",
"state": "AR",
"postal_code": "720348679",
"telephone_number": "501-327-1730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GASPARD",
"first_name": "BRANDI",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-19",
"last_updated": "2021-07-19",
"certification_date": "2021-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": "4591",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPIST ASSISTANT",
"identifier": "PTA4591",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "bgaspard@selectmedical.com",
"affiliation": "N",
"address_1": "2425 Dave Ward Dr Ste 103",
"city": "Conway",
"state": "AR",
"country_code": "US",
"postal_code": "720348679",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.