Tequila S Gordon-Jones

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

License

123577C14 Issued in SC

Practice address

408 Geneva Ave
Marion, SC 29571-5336

Phone

(843) 423-0120

NPI assigned

Apr 6, 2022

Last updated

Apr 6, 2022By the provider in NPPES

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

Electronic endpoints 2

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": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1043951569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 GREYSTONE DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295017030",
            "telephone_number": "843-309-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 GENEVA AVE",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295715336",
            "telephone_number": "843-423-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON-JONES",
        "first_name": "TEQUILA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "SC",
            "license": "123577C14",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgordonjones@bop.gov",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3110 Greystone Dr",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295017030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgordonjones@bop.gov",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3110 Greystone Dr",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295017030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharon D Fuller
• Kathy Funderburk
• Jordan Haley Galloway
• Janel Garrett Vaught, OTR/L
• Allison Germaine Glasscho
• Christina Lyn Gray, LMSW
• Kristen Dozier Gray, NP
• Spencer Gray, PHARMD
• Makiesha Green
• Guardian Angels Professional Services

• Nursing Home Administrator in Marion, SC
• Providers in Marion, SC by specialty
• Nursing Home Administrator in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.