Clarissa Gosnell

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A4361 Issued in MD

Practice address

7407 Willow Rd
Frederick, MD 21702-2500

Phone

(301) 644-5600

NPI assigned

Jan 15, 2019

Last updated

Jan 15, 2019By the provider in NPPES

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

Other identifiers 2

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": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1184198996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2447 BRADDOCK RD",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217718801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7407 WILLOW RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022500",
            "telephone_number": "301-644-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSNELL",
        "first_name": "CLARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A4361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND PT BOARD",
            "identifier": "A4361",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "G-254-119-368-699",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth A Gordon
• Susan Elizabeth Gordon, LCADC-C
• Cole H Gorman, MS OTR/L
• Maghal M Gorre-Ndiaye
• Ravipreet Singh Gosal, MD
• Hannah Goss-Harris
• Logan Rae Goss
• Lisa Gottlieb, LICSW
• Cheryl M Gough, R.N.
• Omar Gowayed, M.D.

• Physical Therapy Assistant in Frederick, MD
• Providers in Frederick, MD by specialty
• Physical Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.