NPIMap

Organization Active NPI

Gordon Physical Therapy, PLLC

  • Physical Therapist
  • Spokane Valley, WA
National Provider Identifier
1265585335
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00002244 Issued in WA
Legal business name
GORDON PHYSICAL THERAPY, PLLC
Practice address
626 N Mullan Rd
# 4
Spokane Valley, WA 99206-3861
Phone
(509) 893-8618
Fax
(509) 892-5462
NPI assigned
Jan 19, 2007
Last updated
Jun 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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

Authorized official

Name
Robert Gordon, PTNPI 1699749499
Title
Owner, Partner
Phone
(509) 892-5442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00002244 WA Primary

Addresses

Primary practice location

626 N Mullan Rd
# 4
Spokane Valley, WA 99206-3861

Mailing address

626 N Mullan Rd
# 4
Spokane Valley, WA 99206-3861
Phone (509) 893-8618

Other names 1

  • Center for Physical and Sports Therapy, PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031223000267 WA Part B Supplier - Clinic/Group Practice 1153229596 Receives reassigned benefits from 16 practitioners
Practice locations: Spokane Valley, WA

National Provider Directory

National Provider Directory

Locations

9304 N Newport Hwy
Spokane, WA 99218
Phone (509) 466-1188

626 N Mullan Rd
Ste 4
Spokane Valley, WA 99206
Phone (509) 892-5442

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1265585335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 N MULLAN RD",
            "address_2": "# 4",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992063861",
            "telephone_number": "509-893-8618",
            "fax_number": "509-892-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 N MULLAN RD",
            "address_2": "# 4",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992063861",
            "telephone_number": "509-893-8618",
            "fax_number": "509-892-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER, PARTNER",
        "authorized_official_telephone_number": "509-892-5442",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Physical and Sports Therapy, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.