Active NPI
Virginia Marie Gillette, PT, MPH
- Physical Therapist
- Roseburg, OR
National Provider Identifier
1972613040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2916
- Practice address
- 913 NW Garden Valley Blvd
Roseburg, OR 97470-6523 - Phone
- (541) 440-1000
- Fax
- (541) 677-3037
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 10936 | CA | |
| Physical Therapist | 225100000X | PT - 893 | HI | |
| Physical Therapist | 225100000X | 2916 | OR | Primary |
Addresses
Primary practice location
913 NW Garden Valley Blvd
Roseburg, OR 97470-6523
Mailing address
623 NE Winchester St
Roseburg, OR 97470-3261
Phone (541) 672-4739
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 10936 | CA | MD | Physical Therapist |
| PT - 893 | HI | MD | Physical Therapist |
| 2916 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972613040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 NE WINCHESTER ST",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974703261",
"telephone_number": "541-672-4739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "913 NW GARDEN VALLEY BLVD",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974706523",
"telephone_number": "541-440-1000",
"fax_number": "541-677-3037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLETTE",
"first_name": "VIRGINIA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "PT, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 10936",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "PT - 893",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "2916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.