Active NPI
Andrew Gordon, ATC
- Athletic Trainer
- Purcellville, VA
National Provider Identifier
1063824340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0126000232
- Practice address
- 340 N Maple Ave
Purcellville, VA 20132-3138 - Phone
- (540) 751-2410
- NPI assigned
- May 21, 2014
- Last updated
- May 21, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0126000232 | VA | Primary |
Addresses
Primary practice location
340 N Maple Ave
Purcellville, VA 20132-3138
Mailing address
340 N Maple Ave
Purcellville, VA 20132-3138
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0126000232 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400630400000",
"number": "1063824340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 N MAPLE AVE",
"city": "PURCELLVILLE",
"state": "VA",
"postal_code": "201323138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 N MAPLE AVE",
"city": "PURCELLVILLE",
"state": "VA",
"postal_code": "201323138",
"telephone_number": "540-751-2410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "ANDREW",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-21",
"last_updated": "2014-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "0126000232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Purcellville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.