MR. JUSTIN E GORDON (DPT) – Physical Therapist, NPI 1205162674

MR. JUSTIN E GORDON (DPT) is a healthcare provider. based in Louisville, Kentucky. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT25049 (FL). The NPI Number for MR. JUSTIN E GORDON (DPT) is 1205162674

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
MR. JUSTIN E GORDON (DPT)
NPI
1205162674
Phone
(502) 882-9379
Address
1650 LYNDON FARM CT STE 300
Enumeration Date
20 October 2009
Last Update Date
23 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9192298363
Graduation Year
2009 (17 years ago)
PAC ID
2062684970
Group Practice PAC ID
9234274754
Professional Enrollment ID
I20231030003405
Address ID
NC275877068WA3150XRDXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:16State licenses:2Digital endpointsOther names

3,664 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NC

Provider Addresses for MR. JUSTIN E GORDON (DPT)

  • 1650 LYNDON FARM CT STE 300

    LOUISVILLE, KY 402235005

    Phone: (502) 882-9379

    Fax: (502) 587-5728

    Type: Mailing

  • 3150 ROGERS RD STE 216

    WAKE FOREST, NC 275877068

    Phone: (919) 229-8363

    Fax: (919) 229-8356

    Type: Location

  • 1075, Mason Avenue, Daytona Beach, Volusia County, Florida, 32117, United States

    DAYTONA BEACH, FL 321174611

    Phone: (386) 255-4596

    Fax: (386) 258-3561

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-10-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231030003405IPhysical Therapist In Private PracticeNCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities4214$0
View full utilization report →

Insurance plans in this area (ZIP 40223)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9234274754View full group profile
NameSpecialtyState
-NC
Physical Therapist In Private PracticeNC
-NC
-NC
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeNC
Physical Therapist In Private PracticeTX
-NC
Physical Therapist In Private PracticeVT
Physical Therapist In Private PracticeNC

Reviews

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Frequently asked questions

Can I use this page to confirm MR. JUSTIN E GORDON (DPT)'s NPI?
Yes. MR. JUSTIN E GORDON (DPT) is listed with NPI 1205162674 in the public NPI dataset.
Does CMS list MR. JUSTIN E GORDON (DPT) as active?
Yes — MR. JUSTIN E GORDON (DPT) is active in the NPI listing used on this page.
What is MR. JUSTIN E GORDON (DPT)'s primary classification?
Physical Therapist is the headline specialty for MR. JUSTIN E GORDON (DPT) here. Clinical services aligned with this taxonomy classification.
Where should I expect MR. JUSTIN E GORDON (DPT) on a map?
Expect Louisville, Kentucky as a primary anchor for MR. JUSTIN E GORDON (DPT) unless the record lists multiple sites.
Why does MR. JUSTIN E GORDON (DPT) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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