Gordium Trauma Recovery, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

PA9108944 Issued in FL

Legal business name

GORDIUM TRAUMA RECOVERY, LLC

Practice address

4723 W Atlantic Ave
Delray Beach, FL 33445-3895

Phone

(156) 156-2067

Fax

(156) 126-5567

NPI assigned

Aug 29, 2016

Organization subpart

No

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

Authorized official

Name

Arpana Shivdasani, P.A.

Title

Physicians Assistant

Phone

(561) 562-0674

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1487100533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4723 W ATLANTIC AVE STE A11",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334453895",
            "telephone_number": "156-156-2067",
            "fax_number": "561-265-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4723 W ATLANTIC AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334453895",
            "telephone_number": "156-156-2067",
            "fax_number": "156-126-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDIUM TRAUMA RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "SHIVDASANI",
        "authorized_official_first_name": "ARPANA",
        "authorized_official_title_or_position": "PHYSICIANS ASSISTANT",
        "authorized_official_telephone_number": "15615620674",
        "authorized_official_credential": "P.A."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "PA9108944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven I Goodman, M.D.
• Beatriz Gordillo
• Gordium Medical Services
• Gordium Mental Health
• Gordium RX, LLC
• Nicanda Norrie Gordon, MD
• Ryan Michael Gore
• Roger Shelley Gorman, MD
• Valeria Gorosabel, DAOM
• Emanuel E Gottenger, M.D.

• Community/Behavioral Health Agency in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.