Wayne Gordon, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH9576 Issued in FL

Practice address

228 Ponte Vedra Park Dr
Suite 800
Ponte Vedra Beach, FL 32082-6613

Phone

(904) 418-3937

NPI assigned

Jan 30, 2007

Last updated

Jan 26, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Networks

• FL HMO
• AL HMO D-SNP
• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• FL HMO D-SNP
• AL HMO
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• FL PPO
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• FL HMO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gordon Family Chiropractic Inc

  • Chiropractor
  • Ponte Vedra, FL
  • NPI 1508304783
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1003952573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 PONTE VEDRA PARK DR",
            "address_2": "SUITE 800",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826613",
            "telephone_number": "904-418-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 PONTE VEDRA PARK DR",
            "address_2": "SUITE 800",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826613",
            "telephone_number": "904-418-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008143",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9576",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR008143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Godwin, RBT
• Diane L Goldwater, M.D., PH.D.
• Gonstead Chiropractic Clinic of Jacksonville LLC
• Melissa Gopp-Warner, RDN
• Dawn Gordon
• Padmalatha Gottipati, DDS
• Ashley Mercer Green, BCBA
• Marilyn Greenfield
• Greenlyfe Nutrition, LLC
• Amy Lyn Grobstick, ARNP

• Chiropractor in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.