Individual provider Active NPI

Gina Brock Tramel

  • Physical Therapist
  • Chattanooga, TN
National Provider Identifier
1780089177
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6285 Issued in TN
Practice address
2700 Parkwood Ave
Chattanooga, TN 37404-1730
Phone
(423) 242-7123
NPI assigned
Oct 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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 6285 TN Primary

Addresses

Primary practice location

2700 Parkwood Ave
Chattanooga, TN 37404-1730

Mailing address

2700 Parkwood Ave
Chattanooga, TN 37404-1730
Phone (423) 242-7123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211015000124 TN Practitioner - Physical Therapist in Private Practice 8921406380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

2255 Candies LN NW
Cleveland, TN 37312-2661
Phone (423) 458-1708

2900 Westside Dr NW
Cleveland, TN 37312-3506
Phone (865) 444-1104

6705 Ballard Dr
Chattanooga, TN 37421-2476
Phone (419) 548-8459

8458 Gleason Dr
Knoxville, TN 37919-5482
Phone (865) 474-9837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6285TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Aug 30, 2021 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Aug 30, 2021 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1780089177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 PARKWOOD AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041730",
            "telephone_number": "423-242-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 PARKWOOD AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041730",
            "telephone_number": "423-242-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAMEL",
        "first_name": "GINA",
        "middle_name": "BROCK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "6285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.