Individual provider Active NPI

Sheryl Lynn Gordon, MSN, RN

  • School Registered Nurse
  • Albuquerque, NM
National Provider Identifier
1053810762
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
R27198 Issued in NM
Practice address
3530 Gibson Blvd SE
Albuquerque, NM 87116-3200
Phone
(505) 255-3131
NPI assigned
Feb 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X R27198 NM Primary

Addresses

Primary practice location

3530 Gibson Blvd SE
Albuquerque, NM 87116-3200

Mailing address

7501 Los Lunas Dr NE
Albuquerque, NM 87109-4927
Phone (505) 264-1370

Other identifiers 1

IdentifierTypeStateIssuer
R27198OtherNMNEW MEXICO STATE BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R27198NMMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1053810762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 LOS LUNAS DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094927",
            "telephone_number": "505-264-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 GIBSON BLVD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871163200",
            "telephone_number": "505-255-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SHERYL",
        "middle_name": "LYNN",
        "credential": "MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NM",
            "license": "R27198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO STATE BOARD OF NURSING",
            "identifier": "R27198",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.