Individual provider Active NPI

Janelle Gibson, D.P.T

  • Physical Therapist
  • Missoula, MT
National Provider Identifier
1629444799
Registry record updated Nov 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19266 Issued in MT
Practice address
2831 Fort Missoula Rd
Building 2, Suite 232
Missoula, MT 59804-7479
Phone
(406) 200-8488
Fax
(406) 213-3518
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0013541 CO
Physical Therapist 225100000X 1262305 TX
Physical Therapist 225100000X 19266 MT Primary

Addresses

Primary practice location

2831 Fort Missoula Rd
Building 2, Suite 232
Missoula, MT 59804-7479

Mailing address

179 Fairway Dr
Missoula, MT 59803-2404
Phone (806) 236-3124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, MT, CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20151002002449 CO Practitioner - Physical Therapist in Private Practice 5092023523 Reassigns benefits to 1 organization
I20220819002174 MT Practitioner - Physical Therapist in Private Practice 5092023523 Reassigns benefits to 1 organization
I20251230002916 CA Practitioner - Physical Therapist in Private Practice 5092023523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Pasadena, CA 91189

PO Box
Suite 104341
Pasadena, CA 91189-0406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0013541COMDPhysical Therapist
19266MTMDPhysical Therapist
1262305TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bitterroot Pelvic Therapy D/B/a Wellspring Pelvic Health Physical Therapist CurrentSince Jul 1, 2021 Accepting new patients
Coal Creek Physical Therapy, LLC Physical Therapist CurrentSince Aug 24, 2015 Accepting new patients
Dodge Works PT, Inc Dba Alpine Physical Therapy Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients
Origin Physical Therapy Ca Inc Physical Therapist CurrentSince Dec 17, 2025 Accepting new patients
Dodge Works PT, Inc Dba Alpine Physical Therapy Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients
Coal Creek Diagnostics, LLC PastSince Aug 24, 2015 Accepting new patients

Locations

7188 Avenida Encinas
Ste 110
Carlsbad, CA 92011

11980 San Vicente Blvd
Ste 100
Los Angeles, CA 90049
Phone (310) 479-2323

315 W South Boulder Rd
Ste 100
Louisville, CO 80027
Phone (303) 601-6666

2965 Stockyard Rd
Missoula, MT 59808
Phone (406) 251-2323

736 S 1st St W
Ste A
Missoula, MT 59801
Phone (406) 239-4136

2831 Fort Missoula Rd
Ste 232
Missoula, MT 59804
Phone (406) 523-5650

5000 Blue Mountain Rd
Missoula, MT 59804
Phone (406) 251-2323

Organizations & group practices 6

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": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636243200000",
    "number": "1629444799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 FAIRWAY DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598032404",
            "telephone_number": "806-236-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 FORT MISSOULA RD",
            "address_2": "BUILDING 2, SUITE 232",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047479",
            "telephone_number": "406-200-8488",
            "fax_number": "406-213-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JANELLE",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2021-11-07",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0013541",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1262305",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "19266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; 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.