Active NPI
Jillian Marie Gorman, PT
- Physical Therapist
- Lackawanna, NY
National Provider Identifier
1851640072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 035205-1
- Practice address
- 790 Ridge Rd
Lackawanna, NY 14218-1629 - Phone
- (716) 822-4781
- NPI assigned
- Sep 4, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 035205-1 | NY | Primary |
Addresses
Primary practice location
790 Ridge Rd
Lackawanna, NY 14218-1629
Mailing address
1543 Center Rd
West Seneca, NY 14224-3288
Phone (716) 912-4495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035205-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476057600000",
"number": "1851640072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1543 CENTER RD",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142243288",
"telephone_number": "716-912-4495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 RIDGE RD",
"city": "LACKAWANNA",
"state": "NY",
"postal_code": "142181629",
"telephone_number": "716-822-4781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "JILLIAN",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-04",
"last_updated": "2016-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "035205-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lackawanna, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.