Individual provider Active NPI

Alana A Gillenwater, DPT

  • Physical Medicine & Rehabilitation Physician
  • Gassaway, WV
National Provider Identifier
1710407960
Registry record updated Jun 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT003799 Issued in WV
Practice address
155 Reston PL
Gassaway, WV 26624-9356
Phone
(304) 364-9191
Fax
(304) 364-9193
NPI assigned
Jun 20, 2017
Last updated
Jun 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT003799 WV Primary

Addresses

Primary practice location

155 Reston PL
Gassaway, WV 26624-9356

Mailing address

3942 Davis Stuart Rd Ste 3
Ronceverte, WV 24970-0269
Phone (304) 647-3987

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT003799WVMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497916800000",
    "number": "1710407960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3942 DAVIS STUART RD STE 3",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249700269",
            "telephone_number": "304-647-3987",
            "fax_number": "304-647-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 RESTON PL",
            "city": "GASSAWAY",
            "state": "WV",
            "postal_code": "266249356",
            "telephone_number": "304-364-9191",
            "fax_number": "304-364-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLENWATER",
        "first_name": "ALANA",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2017-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WV",
            "license": "PT003799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gassaway, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; 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.