Active NPI
Gail Deann Smith, PT
- Physical Therapist
- Sunriver, OR
National Provider Identifier
1891769790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1375
- Practice address
- 56881 Enterprise Dr
Sunriver, OR 97707 - Phone
- (541) 593-8535
- Fax
- (541) 593-0316
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1375 | OR | Primary |
Addresses
Primary practice location
56881 Enterprise Dr
Sunriver, OR 97707
Mailing address
56749 Spring River Loop
Bend, OR 97707
Phone (541) 593-6167
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 184473 | Medicaid | OR |
Other names 1
- Gail Deann Rourke
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1375 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280707200000",
"number": "1891769790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56749 SPRING RIVER LOOP",
"city": "BEND",
"state": "OR",
"postal_code": "97707",
"telephone_number": "541-593-6167",
"fax_number": "541-593-0316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56881 ENTERPRISE DR",
"city": "SUNRIVER",
"state": "OR",
"postal_code": "97707",
"telephone_number": "541-593-8535",
"fax_number": "541-593-0316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "GAIL",
"middle_name": "DEANN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-15",
"last_updated": "2010-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "1375",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184473",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GAIL",
"last_name": "ROURKE",
"middle_name": "DEANN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Sunriver, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.