Active NPI
Anne Carol Gordon, PT
- Physical Therapist
- Casa Grande, AZ
National Provider Identifier
1376683607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0809
- Practice address
- 1460 N Pinal Ave
Casa Grande, AZ 85222-3337 - Phone
- (520) 876-3614
- NPI assigned
- Feb 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 0809 | AZ | Primary |
Addresses
Primary practice location
1460 N Pinal Ave
Casa Grande, AZ 85222-3337
Mailing address
16616 S 37TH Way
Phoenix, AZ 85048-7967
Phone (480) 759-1999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 590936 | Other | AZ | AHCCCS |
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 |
|---|---|---|---|
| 0809 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376683607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16616 S 37TH WAY",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850487967",
"telephone_number": "480-759-1999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1460 N PINAL AVE",
"city": "CASA GRANDE",
"state": "AZ",
"postal_code": "852223337",
"telephone_number": "520-876-3614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "ANNE",
"middle_name": "CAROL",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "0809",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "590936",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Casa Grande, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.