Katrine Gordon, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10817 Issued in AZ

Practice address

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831

Phone

(928) 537-6537

Fax

(928) 367-5778

NPI assigned

Jun 19, 2014

Last updated

Jun 19, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1669886487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37809 N 17TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850868770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E SHOW LOW LAKE RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017831",
            "telephone_number": "928-537-6537",
            "fax_number": "928-367-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KATRINE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ghulam Mustafa LLC
• Laura Rennie Gibson, CNM
• Kenneth A Giles, MD
• William Gonzalez, L.C.S.W.
• Brian William Goodman, DO
• Steven F Gorman-Hackstadt, RPH
• Tabatha Grace
• Guardian Flight LLC
• Guardian Flight LLC
• Guardian Flight LLC

• Physical Therapist in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.