Individual provider Active NPI

Gina Rawls, PTA

  • Specialist
  • Mount Juliet, TN
National Provider Identifier
1578832275
Registry record updated Dec 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3869 Issued in TN
Practice address
5525 Creole Way
Mount Juliet, TN 37122-8806
Phone
(615) 516-2479
NPI assigned
Dec 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 3869 TN Primary

Addresses

Primary practice location

5525 Creole Way
Mount Juliet, TN 37122-8806

Mailing address

5525 Creole Way
Mount Juliet, TN 37122-8806
Phone (615) 516-2479

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3869TNMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1324857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324857600000",
    "number": "1578832275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 CREOLE WAY",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371228806",
            "telephone_number": "615-516-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 CREOLE WAY",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371228806",
            "telephone_number": "615-516-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLS",
        "first_name": "GINA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-26",
        "last_updated": "2011-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "3869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2011; 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.