Roena Faye Gabbard, OTR/L

Primary specialty

SpecialistTaxonomy code 174400000X

License

KYR0715 Issued in KY

Practice address

2000 Jacks Creek Rd
Richmond, KY 40475-9406

Phone

(859) 623-4240

Fax

(859) 623-4288

NPI assigned

Sep 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1457456501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 JACKS CREEK RD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404759406",
            "telephone_number": "859-623-4240",
            "fax_number": "859-623-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 JACKS CREEK RD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404759406",
            "telephone_number": "859-623-4240",
            "fax_number": "859-623-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABBARD",
        "first_name": "ROENA",
        "middle_name": "FAYE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "KYR0715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GO-200",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST STEPS PROVIDER",
            "identifier": "1485",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marcy S Gagnon, PT
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• Lauren Gall, DPT
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• Specialist in Richmond, KY
• Providers in Richmond, KY by specialty
• Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.