Active NPI
Ike B Gorman, DPM.,PC
- Podiatrist
- Tucson, AZ
National Provider Identifier
1528028115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 301
- Practice address
- 1500 N Wilmot Rd
Ste A230
Tucson, AZ 85712-4416 - Phone
- (520) 722-5115
- Fax
- (520) 722-0611
- NPI assigned
- Mar 27, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 301 | AZ | Primary |
Addresses
Primary practice location
1500 N Wilmot Rd
Ste A230
Tucson, AZ 85712-4416
Mailing address
PO Box 69040
Tucson, AZ 85737
Phone (520) 722-5115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700981 | Medicaid | AZ |
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 |
|---|---|---|---|
| 301 | AZ | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Chiropractic Physicians LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Tucson, AZ
- NPI 1457524993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305590400000",
"number": "1528028115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 69040",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85737",
"telephone_number": "520-722-5115",
"fax_number": "520-722-0611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 N WILMOT RD",
"address_2": "STE A230",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857124416",
"telephone_number": "520-722-5115",
"fax_number": "520-722-0611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "IKE",
"middle_name": "B",
"credential": "DPM.,PC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-27",
"last_updated": "2011-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "AZ",
"license": "301",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "700981",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.