Tina Marie Gordon

Primary specialty

Adult CompanionTaxonomy code 372600000X

Practice address

4657 E Odessa Dr
Queen Creek, AZ 85140-4516

Phone

(951) 305-1462

NPI assigned

Dec 2, 2022

Last updated

Dec 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1053021733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4657 E ODESSA DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851404516",
            "telephone_number": "951-305-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4657 E ODESSA DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851404516",
            "telephone_number": "951-305-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN HOME CARE FOR ELDERLY",
            "identifier": "88-07544070",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Good Health Medical, PLLC (My Dr Now)
• Good Health Medical, PLLC (My Dr Now)
• Good Life Dental
• Zachary Goodenberger, RBT
• Kassandra Marie Gordon, RDH
• Evan McFarlin Goreham
• Jade Faith Gottschalk, DDS
• Graceful Path Psychiatry, PLLC
• Dorsey Gradis, ANP
• Jonathan Graff, D.O.

• Adult Companion in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Adult Companion in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.