Individual provider Active NPI

Deborah Gill, PTA

  • Physical Therapy Assistant
  • Bowling Green, KY
National Provider Identifier
1992436208
Registry record updated Jun 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A04235 Issued in KY
Practice address
5079 Scottsville Rd
Bowling Green, KY 42104-7897
Phone
(270) 782-1125
NPI assigned
Jun 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A04235 KY Primary

Addresses

Primary practice location

5079 Scottsville Rd
Bowling Green, KY 42104-7897

Mailing address

125 Peach Blossom LN
Bowling Green, KY 42103-7057
Phone (724) 967-3174

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Debbiecoon1979@gmail.com

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

LicenseStateTypeSpecialty
A04235KYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1655596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655596800000",
    "number": "1992436208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PEACH BLOSSOM LN",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037057",
            "telephone_number": "724-967-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5079 SCOTTSVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421047897",
            "telephone_number": "270-782-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "DEBORAH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-19",
        "last_updated": "2022-06-19",
        "certification_date": "2022-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KY",
            "license": "A04235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Debbiecoon1979@gmail.com",
            "affiliation": "N",
            "address_1": "125 Peach Blossom Ln",
            "city": "Bowling Green",
            "state": "KY",
            "country_code": "US",
            "postal_code": "421037057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2022; 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.