Evan Ivory Gordy, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA31629 Issued in FL

Practice address

10300 4TH St N
Saint Petersburg, FL 33716-3813

Phone

(727) 568-1000

NPI assigned

Nov 21, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1637452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637452800000",
    "number": "1083371371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10624 CORY LAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472995",
            "telephone_number": "813-727-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 4TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337163813",
            "telephone_number": "727-568-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDY",
        "first_name": "EVAN",
        "middle_name": "IVORY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-21",
        "last_updated": "2021-11-21",
        "certification_date": "2021-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA31629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen L Gordon, RDH
• Mark R. Gordon, M.D.
• Morgan James Gordon
• Susan Lee Gordon, D.D.S.
• Erin Melissa Gordy, PA-C
• Jonathan Edward Gordy, NP
• Kathleen M Gorman
• Diane Louise Goss, LCSW
• Guy Carlton Goss
• John Kevin Gossett, PHARMD

• Physical Therapy Assistant in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2021; 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.