Individual provider Active NPI

Kimberly Gordon, P.T.

  • Orthopedic Physical Therapist
  • Rochester, MN
National Provider Identifier
1063646511
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
7654 Issued in MN
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

Updated by the provider on Aug 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
7654MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy of Palmetto Inc Orthopedic Past Accepting new patients
Pursuitpt LLC Orthopedic PastSince Mar 7, 2021 Accepting new patients
Advanced Physical Therapy of Venice Inc Orthopedic PastSince Aug 4, 2023 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.

Verify at the official NPI Registry.