Jennifer Gordon, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

21047 Issued in MD

Practice address

14999 Health Center Dr Ste 201
Bowie, MD 20716-1087

Phone

(240) 245-4245

Fax

(240) 245-4916

NPI assigned

Mar 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Jennifer Chiaravallotti Former name

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mosaddegh Physical Therapy Inc

  • Physical Therapist
  • Greenbelt, MD
  • NPI 1376841148

  DC

  Medicare reassignment NPD
• Mosaddegh Physical Therapy Inc.

  • Physical Therapist
  • Silver Spring, MD
  • NPI 1316588767
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1487615027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 HANOVER PKWY STE 103",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702011",
            "telephone_number": "301-446-1644",
            "fax_number": "301-446-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14999 HEALTH CENTER DR STE 201",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161087",
            "telephone_number": "240-245-4245",
            "fax_number": "240-245-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336407100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CHIARAVALLOTTI",
            "prefix": "MS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Good Day Wellness Care LLC
• Maya Goode
• Adeola Goodluck
• Kirah Goodridge
• Gordon Formica & Love DDS PA
• Dante Lemar Gorham, PT
• Gosimple Nutrition LLC
• Diane Patrice Goyette, RPH, JD
• Grace & Dignity Care LLC
• Grace & Mercy Community Services Inc.

• Physical Therapist in Bowie, MD
• Providers in Bowie, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.