Active NPI
Jordan Bormann
- Physical Therapist
- Louisville, KY
National Provider Identifier
1235491754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT006022
- Practice address
- 4420 Dixie Hwy
Suite 122
Louisville, KY 40216-2988 - Phone
- (502) 447-2750
- Fax
- (502) 449-9062
- NPI assigned
- Jun 11, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT27344 | FL | |
| Physical Therapist | 225100000X | PT006022 | KY | Primary |
Addresses
Primary practice location
4420 Dixie Hwy
Suite 122
Louisville, KY 40216-2988
Mailing address
4420 Dixie Hwy
Suite 122
Louisville, KY 40216-2988
Phone (502) 447-2750
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT27344 | FL | MD | Physical Therapist |
| PT006022 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362614400000",
"number": "1235491754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4420 DIXIE HWY",
"address_2": "SUITE 122",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402162988",
"telephone_number": "502-447-2750",
"fax_number": "502-449-9062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4420 DIXIE HWY",
"address_2": "SUITE 122",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402162988",
"telephone_number": "502-447-2750",
"fax_number": "502-449-9062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORMANN",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-11",
"last_updated": "2013-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT27344",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "PT006022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.