Individual provider Active NPI

Gayla Michele Spencer, PT

  • Physical Therapist
  • Leawood, KS
National Provider Identifier
1477591220
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-03462 Issued in KS
Practice address
9425 Mission Rd
Leawood, KS 66206-2045
Phone
(913) 381-2100
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 11-03462 KS Primary

Addresses

Primary practice location

9425 Mission Rd
Leawood, KS 66206-2045

Mailing address

200 W Douglas Ave Ste 250
Wichita, KS 67202-3002
Phone (316) 263-0003

Other identifiers 2

IdentifierTypeStateIssuer
36503053OtherBCBS KC
KA2868021OtherKSMEDICARE PTAN

Other names 1

  • Gayla Michelle Burrell Former name

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

LicenseStateTypeSpecialty
11-03462KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred PT, LLC Physical Therapist CurrentSince Sep 4, 2022 Accepting new patients
Aspire Back Pain & Rehab Clinic Physical Therapist Past Accepting new patients

Locations

200 W Douglas Ave
Ste 250
Wichita, KS 67202
Phone (316) 265-9922

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1477591220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W DOUGLAS AVE STE 250",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023002",
            "telephone_number": "316-263-0003",
            "fax_number": "813-524-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9425 MISSION RD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662062045",
            "telephone_number": "913-381-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "GAYLA",
        "middle_name": "MICHELE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "36503053",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "KA2868021",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAYLA",
            "last_name": "BURRELL",
            "middle_name": "MICHELLE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leawood, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.