Individual provider Active NPI

Traci Gilbert, LPT

  • Physical Therapist
  • Jasper, IN
National Provider Identifier
1720411739
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05011229A Issued in IN
Practice address
600 W 13TH St
Suite 200
Jasper, IN 47546-1883
Phone
(812) 482-7441
Fax
(812) 482-7444
NPI assigned
Aug 13, 2013
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05011229A IN Primary

Addresses

Primary practice location

600 W 13TH St
Suite 200
Jasper, IN 47546-1883

Mailing address

600 W 13TH St
Suite 200
Jasper, IN 47546-1883
Phone (812) 482-7441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131126000251 IN Practitioner - Physical Therapist in Private Practice 5193951010 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05011229AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel C Eby D.O. PC CurrentSince Jul 9, 2013 Accepting new patients
Tretter Physical Therapy PC Physical Therapist Current Accepting new patients

Locations

600 W 13th St
Ste 200
Jasper, IN 47546
Phone (812) 482-7441

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1720411739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 13TH ST",
            "address_2": "SUITE 200",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475461883",
            "telephone_number": "812-482-7441",
            "fax_number": "812-482-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 13TH ST",
            "address_2": "SUITE 200",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475461883",
            "telephone_number": "812-482-7441",
            "fax_number": "812-482-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "TRACI",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011229A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.