Individual provider Active NPI

Gordon L. King, P.T.

  • Physical Therapist
  • Parma, OH
National Provider Identifier
1164614848
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 003595 Issued in OH
Practice address
6115 Powers Blvd
Suite 100
Parma, OH 44129-5471
Phone
(440) 888-7855
Fax
(440) 888-7862
NPI assigned
Aug 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 003595 OH Primary

Addresses

Primary practice location

6115 Powers Blvd
Suite 100
Parma, OH 44129-5471

Mailing address

PO Box 378
Sandusky, OH 44871-0378
Phone (419) 609-1112

Other identifiers 1

IdentifierTypeStateIssuer
2860720MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071026000385 OH Practitioner - Physical Therapist in Private Practice 1850488628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 W Strub Rd
Sandusky, OH 44870-5390
Phone (419) 626-6161

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
59.13
Promoting interoperability
99
Improvement activities
40
Cost
75.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 003595OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists LLC CurrentSince Jan 1, 2017 Accepting new patients
Northern Ohio Medical Specialists, LLC CurrentSince Jan 1, 2017 Accepting new patients
Northern Ohio Medical Specialists, LLC Past Accepting new patients
Southwest Orthopaedics, Inc. Past Accepting new patients

Locations

15299 Bagley Rd
Ste 100
Middleburg Heights, OH 44130
Phone (440) 816-6432

6820 Ridge Rd
Parma, OH 44129
Phone (440) 842-1570

6115 Powers Blvd
Ste 100
Parma, OH 44129
Phone (440) 842-1570

2500 W Strub Rd
Sandusky, OH 44870
Phone 41960911123061

3004 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-2841

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1164614848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448710378",
            "telephone_number": "419-609-1112",
            "fax_number": "419-609-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 POWERS BLVD",
            "address_2": "SUITE 100",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441295471",
            "telephone_number": "440-888-7855",
            "fax_number": "440-888-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "GORDON",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT 003595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2860720",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.