GORDON BLAKE SIMMONS – Physical Therapist, NPI 1164287504

GORDON BLAKE SIMMONS is a healthcare provider. based in Prosper, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. The NPI Number for GORDON BLAKE SIMMONS is 1164287504

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
GORDON BLAKE SIMMONS
NPI
1164287504
Phone
(214) 402-4704
Address
3531 BRIARCLIFF DR
Enumeration Date
15 February 2024
Last Update Date
15 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2145090029
Graduation Year
2023 (3 years ago)
PAC ID
8123466125
Group Practice PAC ID
3274998224
Professional Enrollment ID
I20240410001592
Address ID
TX750134957AL1101XCIRX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

5,355 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for GORDON BLAKE SIMMONS

  • 3531 BRIARCLIFF DR

    PROSPER, TX 750781609

    Phone: (214) 402-4704

    Type: Mailing

  • 1101 RAINTREE CIR

    ALLEN, TX 750134922

    Phone: (214) 509-0029

    Type: Location

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: 2024-04-10

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
I20240410001592IPhysical Therapist In Private PracticeTXTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75078)

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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: 3274998224View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeNC
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeLA
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX

Reviews

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Frequently asked questions

What number should I use to identify GORDON BLAKE SIMMONS for billing?
Administrative and clinical systems typically use NPI 1164287504 for GORDON BLAKE SIMMONS.
Should I treat GORDON BLAKE SIMMONS as an active provider?
Patients and plans typically see GORDON BLAKE SIMMONS as active in the national extract.
What does the directory say GORDON BLAKE SIMMONS does?
Insurance directories may phrase it differently, but here GORDON BLAKE SIMMONS maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to GORDON BLAKE SIMMONS?
GORDON BLAKE SIMMONS is associated with Prosper, Texas in the same public data insurers reference.
Why is information missing for GORDON BLAKE SIMMONS?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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