Healthcare Provider Details

I. General information

NPI: 1174360598
Provider Name (Legal Business Name): REBECCA ANNE GILBERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 STONECREST PKWY STE 100
SMYRNA TN
37167-6827
US

IV. Provider business mailing address

29 TAYLOR AVE
CROSSVILLE TN
38555-4527
US

V. Phone/Fax

Practice location:
  • Phone: 615-223-7227
  • Fax: 615-891-5002
Mailing address:
  • Phone: 931-484-6061
  • Fax: 931-614-7523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6777
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number6777
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: