Rachael Marie Gordon

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6750 S Highland Dr Ste 100
Cottonwood Heights, UT 84121-3019

Phone

(801) 685-7246

NPI assigned

Sep 15, 2020

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

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Spine Care Center, LLC

  • Interventional Pain Medicine Physician
  • Cottonwood Heights, UT
  • NPI 1992736557
  Medicare reassignment

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1689289787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 S HIGHLAND DR STE 100",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841213019",
            "telephone_number": "801-685-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 S HIGHLAND DR STE 100",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841213019",
            "telephone_number": "801-685-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "RACHAEL",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keaton Jeffery Glassey
• Goal Pediatric Orthotics LLC
• Rachel Goff
• Cora Goldsmith
• John Carlos Gonzales
• Sasha Nicole Gordon, MTRS, CTRS
• Emily Granillo
• Bonnie L Granzin
• Daniel Joseph Gray
• Madison Kyleigh Groves

• Physician Assistant in Cottonwood Heights, UT
• Providers in Cottonwood Heights, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.