Kristin N Gordon

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006829 Issued in KY

Practice address

605 S Jefferson St
Princeton, KY 42445-2173

Phone

(502) 253-4914

Fax

(502) 489-5751

NPI assigned

Jun 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1003474925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PKWY STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-253-4914",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S JEFFERSON ST",
            "city": "PRINCETON",
            "state": "KY",
            "postal_code": "424452173",
            "telephone_number": "502-253-4914",
            "fax_number": "502-489-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KRISTIN",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "006829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgordon50209@bhkydirect.com",
            "affiliation": "N",
            "address_1": "605 S Jefferson St",
            "city": "Princeton",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424452173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Princeton, KY
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.