Active NPI
Raymond Gorman
- Physical Therapist
- Sparks, NV
National Provider Identifier
1043623820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2977
- Practice address
- 1450 E Prater Way
Suite 103
Sparks, NV 89434-8972 - Phone
- (775) 331-1199
- Fax
- (775) 331-1199
- NPI assigned
- Jun 9, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2977 | NV | Primary |
Addresses
Primary practice location
1450 E Prater Way
Suite 103
Sparks, NV 89434-8972
Mailing address
1450 E Prater Way
Suite 103
Sparks, NV 89434-8972
Phone (775) 331-1199
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2977 | NV | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403481600000",
"number": "1043623820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 E PRATER WAY",
"address_2": "SUITE 103",
"city": "SPARKS",
"state": "NV",
"postal_code": "894348972",
"telephone_number": "775-331-1199",
"fax_number": "775-331-1199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 E PRATER WAY",
"address_2": "SUITE 103",
"city": "SPARKS",
"state": "NV",
"postal_code": "894348972",
"telephone_number": "775-331-1199",
"fax_number": "775-331-1199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "RAYMOND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-09",
"last_updated": "2014-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "2977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparks, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.