Individual provider Active NPI

Christopher Scott Gordos, DPT

  • Physical Therapist
  • Fleetwood, PA
National Provider Identifier
1780651091
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011166L Issued in PA
Practice address
805 N Richmond St
Suite 103
Fleetwood, PA 19522-1058
Phone
(610) 944-8140
Fax
(610) 944-8190
NPI assigned
Mar 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011166L PA Primary

Addresses

Primary practice location

805 N Richmond St
Suite 103
Fleetwood, PA 19522-1058

Mailing address

805 N Richmond St
Suite 103
Fleetwood, PA 19522-1058
Phone (610) 944-8140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091223000406 PA Practitioner - Physical Therapist in Private Practice 0840330841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

805 N Richmond St
Suite 103
Fleetwood, PA 19522-1059
Phone (610) 944-8140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT011166LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group P C CurrentSince Dec 1, 2009 Accepting new patients
Integrated Medical Group, P.C. CurrentSince Dec 1, 2009 Accepting new patients
Img PT Physical Therapist Past Accepting new patients

Locations

805 N Richmond St
Ste 103
Fleetwood, PA 19522
Phone (610) 944-0464

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1780651091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N RICHMOND ST",
            "address_2": "SUITE 103",
            "city": "FLEETWOOD",
            "state": "PA",
            "postal_code": "195221058",
            "telephone_number": "610-944-8140",
            "fax_number": "610-944-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N RICHMOND ST",
            "address_2": "SUITE 103",
            "city": "FLEETWOOD",
            "state": "PA",
            "postal_code": "195221058",
            "telephone_number": "610-944-8140",
            "fax_number": "610-944-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDOS",
        "first_name": "CHRISTOPHER",
        "middle_name": "SCOTT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-06",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT011166L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleetwood, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; 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.