Gina Patricia Gordon

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201006870 Issued in MI

Practice address

1117 Riverstone Cir
Milford, MI 48381-2090

Phone

(248) 767-0873

NPI assigned

Mar 31, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • Shelby Township, MI
  • NPI 1912226366

  Single Specialty

  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1700414265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 RIVERSTONE CIR",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483812090",
            "telephone_number": "248-767-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 RIVERSTONE CIR",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483812090",
            "telephone_number": "248-767-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GINA",
        "middle_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "5201006870",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald A. Glass, LLBSW, CADC-DP
• Andrew Glidden, LLMSW
• Karen Lynne Goldy, AGAC-NP
• Nikhila Devi Goli, DDS
• Russell Bryant Goodman
• Kara Graham
• Nicole Dawn Grange, PA-C
• Paige Catherine Grass
• Courtney Graves, NP
• Green Energ, Inc

• Occupational Therapist in Milford, MI
• Providers in Milford, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.