Active NPI
Jon-Marc Gowan, PTA
- Physical Therapy Assistant
- Milan, TN
National Provider Identifier
1669948311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 6257
- Practice address
- 8017 Dogwood LN
Milan, TN 38358-6805 - Phone
- (731) 686-8373
- NPI assigned
- Oct 21, 2018
- Last updated
- Oct 21, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 6257 | TN | Primary |
Addresses
Primary practice location
8017 Dogwood LN
Milan, TN 38358-6805
Mailing address
3935 Highway 70
Cedar Grove, TN 38321-7437
Phone (731) 676-3788
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6257 | TN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540080000000",
"number": "1669948311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3935 HIGHWAY 70",
"city": "CEDAR GROVE",
"state": "TN",
"postal_code": "383217437",
"telephone_number": "731-676-3788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8017 DOGWOOD LN",
"city": "MILAN",
"state": "TN",
"postal_code": "383586805",
"telephone_number": "731-686-8373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOWAN",
"first_name": "JON-MARC",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-21",
"last_updated": "2018-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "6257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milan, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.