Gentry Renee Purnell

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2011031150 Issued in MO

Practice address

4405 Evans to Locks Road
Evans, GA 30906-7909

Phone

(706) 854-1598

NPI assigned

Jan 25, 2012

Last updated

Dec 3, 2012By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• In Home Pediatric Therapy Inc

  • Pediatric Occupational Therapist
  • Evans, GA
  • NPI 1407983232
  NPD (past)

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1720359540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 COLLINS DRIVE",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "30907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 EVANS TO LOCKS ROAD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "309067909",
            "telephone_number": "706-854-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURNELL",
        "first_name": "GENTRY",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-25",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2011031150",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010826",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PT Solutions of Acworth, LLC
• Publix Super Markets Inc (Publix Pharmacy #0526)
• Publix Super Markets Inc (Publix Pharmacy #1286)
• Kyle W Pulliam, RPH
• Jeffrey Scott Punshon, CSA
• Pyramid Family Behavioral Health (High Focus Centers)
• Tania Qadir, DO
• James Douglas Quarles Jr., MD
• Quasar Internal Medicine Georgia LLC
• Julie Miller Quattlebaum, MD

• Physical Therapist in Evans, GA
• Providers in Evans, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.