Jeffrey Stephen Gordon, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1784 Issued in AK

Practice address

1755 Westwood Way # 7
Fairbanks, AK 99709-4064

Phone

(907) 479-0623

Fax

(888) 761-9303

NPI assigned

Nov 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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

• Fairbanks Physical Therapy LLC

  • Physical Therapist
  • Fairbanks, AK
  • NPI 1922396357
  Medicare reassignment NPD Authorized official
• Home Town Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Fairbanks, AK
  • NPI 1366478935
  NPD (past)
• North Pole Physical Therapy, Inc

  • Orthopedic Physical Therapist
  • North Pole, AK
  • NPI 1639238694
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1215008495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81062",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997081062",
            "telephone_number": "907-479-0623",
            "fax_number": "888-761-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 WESTWOOD WAY # 7",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094064",
            "telephone_number": "907-479-0623",
            "fax_number": "888-761-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JEFFREY",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5926",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1784",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "12294",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT5613",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence A Gooding, M.S. & PH.D.
• Megan Virginia Gooding, LCSW
• Cory Goodman
• Josephine Lynn Gooshaw
• Jeannette Gorda, RN
• Kylie Rae Gore-Hall, PSYD, MS, LP, LPC-S
• Judith Gottschalk, LPC
• Stephanie Leigh Gottschalk, L.AC.
• Pearl J Gould
• Sriharsha Gowtham, MD

• Physical Therapist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Physical Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.