Caroline Anne Gackenbach, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

208692 Issued in AK

Practice address

3009 Boardwalk CT
Glenshaw, PA 15116-2573

Phone

(224) 456-7418

NPI assigned

Apr 24, 2022

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638

  Physical Therapy, WA

  Medicare reassignment NPD
• Presidio Sport & Medicine, Inc.

  • Physical Therapist
  • San Francisco, CA
  • NPI 1578565149

  CA, Physical Therapist

  Medicare reassignment NPD
• Bethesda Physical Therapy

  • Physical Therapist
  • Bethesda, MD
  • NPI 1366508731
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Pediatrics Physician
  • Federal Way, WA
  • NPI 1407409741
  NPD

Medicare fee-for-service enrollment

Enrolled in CA, WA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1650758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1740924943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 BOARDWALK CT",
            "city": "GLENSHAW",
            "state": "PA",
            "postal_code": "151162573",
            "telephone_number": "224-456-7418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 BOARDWALK CT",
            "city": "GLENSHAW",
            "state": "PA",
            "postal_code": "151162573",
            "telephone_number": "224-456-7418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GACKENBACH",
        "first_name": "CAROLINE",
        "middle_name": "ANNE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-24",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VA",
            "license": "2305214918",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": "PT030169",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "28915",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "208692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Glenshaw",
            "affiliation": "N",
            "address_1": "3009 Boardwalk Ct",
            "city": "Glenshaw",
            "state": "PA",
            "country_code": "US",
            "postal_code": "151162573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Amanda N Funari, MS, CCC-SLP
• Functional Roots LLC
• Eric William Gazica, DMD
• Kristen Gephart
• Giant Eagle Inc
• Mayura K Ginde, DDS
• Madison Glew

• All providers in Glenshaw, PA
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; 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.