Justin E Gordon, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P17533 Issued in NC

Practice address

3150 Rogers Rd Ste 216
Wake Forest, NC 27587-7068

Phone

(919) 229-8363

Fax

(919) 229-8356

NPI assigned

Oct 20, 2009

Last updated

Oct 23, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Breakthrough Physical Therapy Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1558598532
  Medicare reassignment NPD
• Breakthrough Physical Therapy

  • Physical Therapist
  • Morehead City, NC
  • NPI 1083937692
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1205162674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "502-882-9379",
            "fax_number": "502-587-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 ROGERS RD STE 216",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275877068",
            "telephone_number": "919-229-8363",
            "fax_number": "919-229-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JUSTIN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-20",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT25049",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P17533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Lynne Goley, FNP
• Monica Kyung-Mi Gomez, RD, LDN
• April R Gonzalez, M.A., CCC-SLP
• Good Thoughts Services, PLLC
• Angela J Good, FNP
• Terence Gordon, CPO
• Margaret Goris, FNP-BC, MSN(R)
• Gorlesky Back & Neck Chiropractic, Inc
• Jack Gorlesky, DC
• Ashley Sarah Gorman, M.S., CF-SLP

• Physical Therapist in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.