Jennifer Gordon, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA001408 Issued in GA

Practice address

311 N Dawson St
Thomasville, GA 31792-5132

Phone

(229) 226-4114

Fax

(229) 226-6480

NPI assigned

May 29, 2014

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)

Not enrolled

State licenses

Practice roles

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.

• Mobility Masters, Inc.

  • Physical Therapist
  • Thomasville, GA
  • NPI 1477066439
  NPD (past)
• Trio Therapy Services, Inc

  • Physical Therapist
  • Thomasville, GA
  • NPI 1518918721
  NPD (past)

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1992117618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1681",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317991681",
            "telephone_number": "229-226-4114",
            "fax_number": "229-226-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N DAWSON ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925132",
            "telephone_number": "229-226-4114",
            "fax_number": "229-226-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JENNIFER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA001408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE NUMBER",
            "identifier": "PTA001408",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark J Glaccum, DC
• Martha E Glose, NP
• Frank Eugene Glover Jr., MD
• Saralyn Grace Goff, FNP-C
• Christopher Golden
• Endia Noel Gosier, FNP
• Jose M Grave de Peralta, MD
• Graves Psychological Services
• Montserrat Mitchell Graves, PH.D.
• Timothy G Grayson, M.D.

• Physical Therapy Assistant in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.