Victoria Gillenwater

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

0000005364 Issued in TN

Practice address

2300 Pavilion Dr
Kingsport, TN 37660-4622

Phone

(423) 765-9655

NPI assigned

Jun 29, 2019

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1561766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561766400000",
    "number": "1669034682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 NELMS ST",
            "city": "SURGOINSVILLE",
            "state": "TN",
            "postal_code": "378733157",
            "telephone_number": "423-444-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PAVILION DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604622",
            "telephone_number": "423-765-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLENWATER",
        "first_name": "VICTORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-29",
        "last_updated": "2019-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "0000005364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleanor Gilbert
• Eric Shawn Gilbert, PHARMD
• Jeffrey Lee Gilbert, PHARMD
• Bill Haywood Gillenwater, D.C.
• Larry Heath Gillenwater, DDS
• Blanton Gillespie
• Camille Gilley, PA-C
• Michelle Denise Gilley, BA
• Tammie Renee Gilliam
• Karen Little Gilmer, MS, CCC-SLP

• Physical Therapy Assistant in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.