Active NPI
Kimberly Gordon, P.T.
- Orthopedic Physical Therapist
- Rochester, MN
National Provider Identifier
1063646511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 7654
- Practice address
- 3100 19TH St NW
Rochester, MN 55901 - Phone
- (507) 322-3460
- Fax
- (507) 322-3450
- NPI assigned
- May 13, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 7654 | MN | Primary |
Addresses
Primary practice location
3100 19TH St NW
Rochester, MN 55901
Mailing address
PO Box 7197
Rochester, MN 55903-7197
Phone (507) 322-3460
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 |
|---|---|---|---|
| 7654 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Physical Therapy of Palmetto Inc | Orthopedic | Past | Accepting new patients |
| Pursuitpt LLC | Orthopedic | Past | Accepting new patients |
| Advanced Physical Therapy of Venice Inc | Orthopedic | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377043200000",
"number": "1063646511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7197",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559037197",
"telephone_number": "507-322-3460",
"fax_number": "507-322-3450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 19TH ST NW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "55901",
"telephone_number": "507-322-3460",
"fax_number": "507-322-3450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "KIMBERLY",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-13",
"last_updated": "2013-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MN",
"license": "7654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.