Jeff Gordon Fenton, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

5460 Issued in WA

Practice address

2507 E 27TH Ave
Spokane, WA 99223-4908

Phone

(509) 456-6917

Fax

(509) 456-5902

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 1991

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Physical Therapy Associates PS

  • Physical Medicine & Rehabilitation Physician
  • Spokane, WA
  • NPI 1306985700
  NPD

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1164561569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 E 27TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234908",
            "telephone_number": "509-456-6917",
            "fax_number": "509-456-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 E 27TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234908",
            "telephone_number": "509-456-6917",
            "fax_number": "509-456-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "JEFF",
        "middle_name": "GORDON",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "5460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8332652",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dom Demetrio Felxi
• Deborah Femreite
• Douglas R. Fender, LICSW, RN
• Alison Jean Fenske, RD
• Bethany Fenton, MD
• Megan Sema Fenton, SLP
• Amy Katherine Fenwick, PH.D., BCBA-D, LBA
• Shann Ferch, PHD
• Michael Todd Ferderer, D.C.
• Michelle Leanne Ferderer, ARNP

• Physical Medicine & Rehabilitation Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.