Mary Dudley Gilbreath, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA4452 Issued in AR

Practice address

705 N Sebastian
West Helena, AR 72390-1822

Phone

(870) 572-9399

NPI assigned

Aug 28, 2019

Last updated

Aug 28, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fenter Physical Therapy LLC

  • Physical Therapist
  • Marion, AR
  • NPI 1992907067
  NPD

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1639727126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W BROADWAY ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723013904",
            "telephone_number": "870-394-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 N SEBASTIAN",
            "city": "WEST HELENA",
            "state": "AR",
            "postal_code": "723901822",
            "telephone_number": "870-572-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBREATH",
        "first_name": "MARY",
        "middle_name": "DUDLEY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA4452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastern Arkansas Diabetic and Medical Supply
• Elaine Pharmacy (Schubach Pharmacy)
• Elaine Pharmacy Inc (Schubach Pharmacy)
• Elaine Pharmacy Inc
• Rochelle Fair, RN
• Theresa Annette Ginn, RN
• Health Resources of Ar
• Vincent Lamonte Henderson, DC
• Hra (Easap)
• Dorothy L. Jones-Michel, APN

• Physical Therapy Assistant in West Helena, AR
• Providers in West Helena, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.