Active NPI
Rene' Lashelle Gordon, DPT
- Pediatric Physical Therapist
- Searcy, AR
National Provider Identifier
1427389345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 3202
- Practice address
- 400 S Main St Ste 500
Searcy, AR 72143-7805 - Phone
- (501) 268-2525
- NPI assigned
- Jan 15, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 3202 | AR | Primary |
Addresses
Primary practice location
400 S Main St Ste 500
Searcy, AR 72143-7805
Mailing address
63 Vilsonia Way
Vilonia, AR 72173-9818
Phone (903) 293-4057
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3202 | AR | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445299200000",
"number": "1427389345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 VILSONIA WAY",
"city": "VILONIA",
"state": "AR",
"postal_code": "721739818",
"telephone_number": "903-293-4057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S MAIN ST STE 500",
"city": "SEARCY",
"state": "AR",
"postal_code": "721437805",
"telephone_number": "501-268-2525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "RENE'",
"middle_name": "LASHELLE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-15",
"last_updated": "2015-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AR",
"license": "3202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Searcy, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.