Active NPI
Corey Gaines, PT
- Physical Therapist
- Tucson, AZ
National Provider Identifier
1427712561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0000011512
- Practice address
- 2040 N Wilmot Rd
Tucson, AZ 85712 - Phone
- (520) 300-6115
- NPI assigned
- Oct 25, 2021
- Sex
- Male
- 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 | 0000011512 | TN | Primary |
Addresses
Primary practice location
2040 N Wilmot Rd
Tucson, AZ 85712
Mailing address
4293 Beaver Creek Lane
Memphis, TN 38125
Phone (901) 356-2852
Other practice location 1
11623 Arbor St
Omaha, NE 68144
Phone (866) 334-1919
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000011512 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1427712561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4293 BEAVER CREEK LANE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38125",
"telephone_number": "901-356-2852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 N WILMOT RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85712",
"telephone_number": "520-300-6115"
}
],
"practiceLocations": [
{
"address_1": "11623 Arbor St",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "68144",
"country_code": "US",
"telephone_number": "866-334-1919",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAINES",
"first_name": "COREY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-25",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "0000011512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.