Gavin Clay Willens, PT, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P23425 Issued in NC

Practice address

200 W Park Cir Ste a
North Wilkesboro, NC 28659-3583

Phone

(336) 818-2700

NPI assigned

Aug 12, 2024

Last updated

Aug 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Prime Physical TherapyGroup PAC ID 7214272525, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Carolina Prime Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • North Wilkesboro, NC
  • NPI 1902392418

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1922839943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 CEDAR RIDGE DR",
            "city": "MILLERS CREEK",
            "state": "NC",
            "postal_code": "286519042",
            "telephone_number": "336-452-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W PARK CIR STE A",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593583",
            "telephone_number": "336-818-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLENS",
        "first_name": "GAVIN",
        "middle_name": "CLAY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilkes Traditional Living
• Wilkes Vocational Services, Inc.
• Wilkesboro Amy Kinlaw PLLC (Kinlaw & Absher Dentistry for Kids)
• Wilkesboro Assisted Living Center, LLC
• Wilkesboro Health and Rehabilitation, LLC
• Sherri L Williams, D.O.
• Lauralee Wilson, MD
• Kinley Morgan Wood, NP
• Faith Wooten, COTA/L
• WRMC Hospital Operating Corporation

• Physical Therapist in North Wilkesboro, NC
• Providers in North Wilkesboro, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.