Individual provider Active NPI

Gemma Lorna Daquipa Mahinay, PT

  • Physical Therapist
  • Mount Vernon, IN
National Provider Identifier
1467659615
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05007883A Issued in IN
Practice address
1282 Main St
Mount Vernon, IN 47620-1365
Phone
(812) 307-1089
Fax
(812) 307-1177
NPI assigned
Jun 29, 2007
Last updated
Mar 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05007883A IN Primary

Addresses

Primary practice location

1282 Main St
Mount Vernon, IN 47620-1365

Mailing address

3325 Yale Dr
Evansville, IN 47711-7305
Phone (502) 552-1422

Other identifiers 1

IdentifierTypeStateIssuer
155238MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170323002757 IN Practitioner - Physical Therapist in Private Practice 6608151188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabfocus LLCGroup PAC ID 1355623414, 2 clinicians

Practice addresses (Care Compare)

1272 Main St
Mount Vernon, IN 47620-1365
Phone (812) 307-1089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabfocus LLC Physical Therapist CurrentSince Mar 1, 2017 Accepting new patients

Locations

1272 Main St
Mount Vernon, IN 47620
Phone (812) 307-1089

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1467659615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 YALE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477117305",
            "telephone_number": "502-552-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1282 MAIN ST",
            "city": "MOUNT VERNON",
            "state": "IN",
            "postal_code": "476201365",
            "telephone_number": "812-307-1089",
            "fax_number": "812-307-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHINAY",
        "first_name": "GEMMA LORNA",
        "middle_name": "DAQUIPA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05007883A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155238",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.