Jacqueline Gordon, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1057 Issued in OK

Practice address

6400 N Santa Fe Ave Ste B
Oklahoma City, OK 73116-9126

Phone

(405) 840-2903

Fax

(405) 840-3256

NPI assigned

Feb 24, 2014

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Focus on Function, Inc.

  • Physical Therapist
  • Edmond, OK
  • NPI 1700950367
  NPD (past)

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1104241488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 REDMAN DR",
            "city": "NEWCASTLE",
            "state": "OK",
            "postal_code": "730655635",
            "telephone_number": "405-361-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 N SANTA FE AVE STE B",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731169126",
            "telephone_number": "405-840-2903",
            "fax_number": "405-840-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JACQUELINE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-24",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "1057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caryn Marie Gordon, LPC, LMFT, NCC
• Courtney Michele Gordon
• David Lee Gordon, M.D.
• Eunkyung Gordon, APRN
• Ian Gordon, PA
• Jana Gordon, COTA/L
• Jefrey Gordon, B.S. BHRS
• Jessica R Gordon
• Justin W Gordon, ATC, LAT
• Liliana Gordon

• Physical Therapy Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.

Verify at the official NPI Registry.