Gordon Davis Rudell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1467 N Mack Smith Rd
East Ridge, TN 37412-3947

Phone

(423) 894-4403

Fax

(423) 894-4513

NPI assigned

Dec 11, 2015

Last updated

Dec 11, 2015By the provider in NPPES

Sex

Male

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

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Tennessee Spine and Sport IncGroup PAC ID 8820013139, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• East Tennessee Spine & Sport Inc

  • Physical Therapist
  • Knoxville, TN
  • NPI 1023101144
  Medicare reassignment Care Compare group NPD
• Independent Physical Therapy, LLC

  dba BenchMark Physical Therapy

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1104878354
  Medicare reassignment NPD
• Knox Physical Therapy, LLC

  dba Knoxville Physical Therapy

  • Physical Therapist
  • Knoxville, TN
  • NPI 1578079372
  NPD (past)

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1821463183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1467 N MACK SMITH RD",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374123947",
            "telephone_number": "423-894-4403",
            "fax_number": "423-894-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDELL",
        "first_name": "GORDON",
        "middle_name": "DAVIS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Byron L Reynolds, P.T.
• Richelle Marie Richey, PHARMD
• Ardyce Jane Ridolfo, MSN,D.PHIL, GNP, FNP
• Lindsay Robinson, DPT
• Jonathan Marius Rodriguez, D.D.S
• Brittany Lee Ryder, FNP-BC
• Scenic City Healthcare of Tennessee, LLC (Southern Heritage Assisted Living)
• Scenic City OB GYN Inc (Womens Health Services Chatt PC DBA University Womens Services)
• Jane Schultz, PHARM.D
• Donna Schwinn, PHARMD

• Physical Therapist in East Ridge, TN
• Providers in East Ridge, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.