Active NPI
Gail Gustavson, DPT
- Physical Therapist
- Peachtree Corners, GA
National Provider Identifier
1477039089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 4825 S Old Peachtree Rd Ste 1100
Peachtree Corners, GA 30071-1504 - Phone
- (770) 449-5152
- Fax
- (866) 821-7683
- NPI assigned
- Jul 17, 2018
- 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 Therapist | 225100000X | Primary |
Addresses
Primary practice location
4825 S Old Peachtree Rd Ste 1100
Peachtree Corners, GA 30071-1504
Mailing address
4825 S Old Peachtree Rd Ste 1100
Peachtree Corners, GA 30071-1504
Phone (770) 449-5152
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531785600000",
"number": "1477039089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4825 S OLD PEACHTREE RD STE 1100",
"city": "PEACHTREE CORNERS",
"state": "GA",
"postal_code": "300711504",
"telephone_number": "770-449-5152",
"fax_number": "866-821-7683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4825 S OLD PEACHTREE RD STE 1100",
"city": "PEACHTREE CORNERS",
"state": "GA",
"postal_code": "300711504",
"telephone_number": "770-449-5152",
"fax_number": "866-821-7683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTAVSON",
"first_name": "GAIL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-17",
"last_updated": "2018-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peachtree Corners, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.