Individual provider Active NPI

Jeni L Gall, DPT

  • Physical Therapist
  • Vancouver, WA
National Provider Identifier
1790863207
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00009183 Issued in WA
Practice address
319 W 33Rd St
Vancouver, WA 98660-1904
Phone
(503) 310-1323
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4940 OR
Physical Therapist 225100000X PT00009183 WA Primary

Addresses

Primary practice location

319 W 33Rd St
Vancouver, WA 98660-1904

Mailing address

319 W 33Rd St
Vancouver, WA 98660-1904
Phone (503) 310-1323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4940ORMDPhysical Therapist
PT00009183WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Orthopedic and Sports Physical Therapy of Gresham LLC PastSince May 19, 2015 Accepting new patients
New Proactive LLC Physical Therapist PastSince May 1, 2017 Accepting new patients
Proactive Orthopedic and Sports Physical Therapy of Battle Ground PastSince Nov 5, 2015 Accepting new patients
Proactive Orthopedic and Sports Physical Therapy of Oregon City LLC PastSince Dec 1, 2014 Accepting new patients

Organizations & group practices 4

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1790863207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 W 33RD ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986601904",
            "telephone_number": "503-310-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 W 33RD ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986601904",
            "telephone_number": "503-310-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALL",
        "first_name": "JENI",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4940",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.