Individual provider Active NPI

Colleen Gorkis-Jones, DPT

  • Pediatric Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1225590623
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
05012560A Issued in IN
Practice address
7209 N Shadeland Ave
Indianapolis, IN 46250-2021
Phone
(317) 620-1018
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 05012560A IN Primary

Addresses

Primary practice location

7209 N Shadeland Ave
Indianapolis, IN 46250-2021

Mailing address

14940 Pacer CT
Carmel, IN 46032-7012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
05012560AINMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Therapy Connection, Inc. CurrentSince Oct 30, 2022 Accepting new patients

Locations

7209 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 288-2760

7478 Shadeland Station Way
Indianapolis, IN 46256
Phone (317) 288-7606

Organizations & group practices 1

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1225590623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14940 PACER CT",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7209 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502021",
            "telephone_number": "317-620-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORKIS-JONES",
        "first_name": "COLLEEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IN",
            "license": "05012560A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.