Active NPI
Seth Gordon, PT
- Physical Therapist
- Roswell, NM
National Provider Identifier
1235761024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT5628
- Practice address
- 72 Gail Harris St
Roswell, NM 88203-8116 - Phone
- (575) 347-3400
- NPI assigned
- Feb 10, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT5628 | NM | Primary |
Addresses
Primary practice location
72 Gail Harris St
Roswell, NM 88203-8116
Mailing address
18 Woodrow Ave
Malden, MA 02148-2618
Phone (573) 881-2128
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 |
|---|---|---|---|
| PT5628 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581292800000",
"number": "1235761024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 WOODROW AVE",
"city": "MALDEN",
"state": "MA",
"postal_code": "021482618",
"telephone_number": "573-881-2128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72 GAIL HARRIS ST",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882038116",
"telephone_number": "575-347-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "SETH",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-10",
"last_updated": "2020-02-10",
"certification_date": "2020-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "PT5628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.