Jillian Gorman, PTA

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

2033 Issued in CT

Practice address

4911 Tall Timber Dr Apt 104
Raleigh, NC 27612-6023

Phone

(203) 560-3380

NPI assigned

Jul 19, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1932772860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 TALL TIMBER DR APT 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126023",
            "telephone_number": "203-560-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 TALL TIMBER DR APT 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126023",
            "telephone_number": "203-560-3380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Hazel Ave",
            "address_purpose": "LOCATION",
            "city": "Naugatuck",
            "state": "CT",
            "postal_code": "067704706",
            "country_code": "US",
            "telephone_number": "203-723-1456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "JILLIAN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "CT",
            "license": "2033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Gordon
• Semaje Gordon
• Akia Gore, LCSWA
• Christishawn Rebecca Gore, MA LPC
• Ronald Gene Gore, MD
• Michael Gorman, PT
• Ashley Lynn Gorrell, PHARMD
• Donna Darlene Gorsch, PT
• April L Gorski, PHARMD
• Monique Goss

• Rehabilitation Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Rehabilitation Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.