Kathleen P Gordon, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL0013011 Issued in CO

Practice address

122 South Main Street
Unit D
Breckenridge, CO 80424

Phone

(970) 453-3990

Fax

(970) 453-2365

NPI assigned

Sep 29, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Core Performance LLC

  • Physical Therapist
  • Bellingham, WA
  • NPI 1003986233
  NPD

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1841709102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5584",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804435584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 SOUTH MAIN STREET",
            "address_2": "UNIT D",
            "city": "BRECKENRIDGE",
            "state": "CO",
            "postal_code": "80424",
            "telephone_number": "970-453-3990",
            "fax_number": "970-453-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KATHLEEN",
        "middle_name": "P",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL0013011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF COLORADO",
            "identifier": "PTL0013011",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eleanor Carmen Gibbs, LCSW
• Melissa Gledhill
• Kellyn Glynn, LPC
• Sabrina Jonelle Goff, D.D.S.
• Edward J Goodman, ATC
• David Julius Gray, MD
• Susan T Greenwood, MS/CCC/SLP
• Tricia Grenier
• Guided Grounds LLC
• Pamela Perga Hafer, PT

• Physical Therapist in Breckenridge, CO
• Providers in Breckenridge, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; 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.