Organization Active NPI

Ike B. Gorman DPM., PC

  • Foot & Ankle Surgery Podiatrist
  • Tucson, AZ
National Provider Identifier
1104095637
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
301 Issued in AZ
Legal business name
IKE B. GORMAN DPM., PC
Practice address
1500 N Wilmot Rd
Suite A230
Tucson, AZ 85712-4416
Phone
(520) 722-5115
Fax
(520) 722-0611
NPI assigned
Feb 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Authorized official

Name
Dr. Ike B Gorman, DPM
Title
Owner
Phone
(520) 722-5115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 301 AZ Primary

Addresses

Primary practice location

1500 N Wilmot Rd
Suite A230
Tucson, AZ 85712-4416

Mailing address

PO Box 69040
Tucson, AZ 85737-0009
Phone (520) 722-5115

Other identifiers 1

IdentifierTypeStateIssuer
700981MedicaidAZ

National Provider Directory

National Provider Directory

Locations

1500 N Wilmot Rd
Ste A230
Tucson, AZ 85712
Phone (520) 722-5115

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305590400000",
    "number": "1104095637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69040",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857370009",
            "telephone_number": "520-722-5115",
            "fax_number": "520-722-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N WILMOT RD",
            "address_2": "SUITE A230",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124416",
            "telephone_number": "520-722-5115",
            "fax_number": "520-722-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IKE B. GORMAN DPM., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2011-05-17",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "IKE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-722-5115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "700981",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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.