Tara Gannon, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT024485 Issued in PA

Practice address

233 E Lancaster Ave
Suite 100
Ardmore, PA 19003-2321

Phone

(610) 642-4494

NPI assigned

Aug 3, 2015

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

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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.

• Pennsylvania Luna Care Physical Therapy LLC

  • Physical Therapist
  • Horsham, PA
  • NPI 1528689445
  Medicare reassignment NPD
• Rehabclinics SPT, Inc.

  • Physical Therapy Clinic/Center
  • Chalfont, PA
  • NPI 1952009482
  NPD (past)
• Rehabclinics Galaxy Inc

  • Physical Therapy Clinic/Center
  • Greenfield, WI
  • NPI 1447250006
  NPD (past)

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1467838466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 GREENHILL RD",
            "city": "LANSDOWNE",
            "state": "PA",
            "postal_code": "190501011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E LANCASTER AVE",
            "address_2": "SUITE 100",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032321",
            "telephone_number": "610-642-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "TARA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT024485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Patrick Foley, PH.D.
• Arlene Foreman, M.S.
• Adrienne Fox-Miniman, MS, CRNP
• Elise Marie Galbo, COTA/L
• Richard Gallagher
• Jasmine Garnett
• Gholston Trust LLC
• Suzanne Y Gladstone
• Leonard H Goldsmith, DPM
• Kara L Goldstein, CRNP

• Physical Therapist in Ardmore, PA
• Providers in Ardmore, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.