Active NPI
Jacqueline A Gorman, PA-C
- Physician Assistant
- Wichita, KS
National Provider Identifier
1518133123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 15-01133
- Practice address
- 9350 E 35TH St N
Suite 101
Wichita, KS 67226-2019 - Phone
- (316) 265-1308
- NPI assigned
- May 3, 2008
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 15-01133 | KS | Primary |
Addresses
Primary practice location
9350 E 35TH St N
Suite 101
Wichita, KS 67226-2019
Mailing address
7627 E 37TH St N
Apt #2001
Wichita, KS 67226-2802
Phone (316) 641-5446
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-01133 | KS | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209772800000",
"number": "1518133123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7627 E 37TH ST N",
"address_2": "APT #2001",
"city": "WICHITA",
"state": "KS",
"postal_code": "672262802",
"telephone_number": "316-641-5446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9350 E 35TH ST N",
"address_2": "SUITE 101",
"city": "WICHITA",
"state": "KS",
"postal_code": "672262019",
"telephone_number": "316-265-1308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "JACQUELINE",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-03",
"last_updated": "2008-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KS",
"license": "15-01133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.