Gina Jelacic

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

5177 Black Gore Dr
Unit B1
Vail, CO 81657-5273

Phone

(970) 688-1433

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Vail Physical Therapy, LLC

  • Physical Therapist
  • Vail, CO
  • NPI 1376162883
  NPD (past)
• Vail Sports Medicine Physical Therapy PC

  • Physical Therapist
  • Vail, CO
  • NPI 1508867227
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593302400000",
    "number": "1790794220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5177 BLACK GORE DR",
            "address_2": "UNIT B1",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5177 BLACK GORE DR",
            "address_2": "UNIT B1",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575273",
            "telephone_number": "970-688-1433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1295 Westhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Vail",
            "state": "CO",
            "postal_code": "816574395",
            "country_code": "US",
            "telephone_number": "970-476-7510",
            "fax_number": "970-476-7511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JELACIC",
        "first_name": "GINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-06-28",
        "certification_date": "2020-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Hsing, PT, DPT
• Samuel Roswell Huntley, MD, MPH
• Taylor Hyde, DPT
• Nica Gabrielle Jacobson, PT, DPT
• Carol Thayer Jaques, M.S., LPC, CACIII
• Addison Rae Jones
• Jenna Lauren Jones, PT
• Justin M Moses DMD PLLC
• Emma Audrey Cannata Kellner, PT
• Joan Elizabeth Kelso, OTR

• Physical Therapist in Vail, CO
• Providers in Vail, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2020; 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.