Shirley Gordon, RN

Primary specialty

Cardiac Rehabilitation Registered NurseTaxonomy code 163WC3500X

License

RN 194973 Issued in OH

Practice address

9975 Dwayne CT
Mentor, OH 44060-7252

Phone

(440) 354-1553

Fax

(440) 354-1553

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 10

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1073531349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9975 DWAYNE CT",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607252",
            "telephone_number": "440-354-1553",
            "fax_number": "440-354-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9975 DWAYNE CT",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607252",
            "telephone_number": "440-354-1553",
            "fax_number": "440-354-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SHIRLEY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OH",
            "license": "RN194973",
            "primary": false
        },
        {
            "code": "163WC3500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Cardiac Rehabilitation",
            "state": "OH",
            "license": "RN 194973",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "OH",
            "license": "RN194973",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "RN 194973",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "RN194973",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "OH",
            "license": "RN194973",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "OH",
            "license": "RN 194973",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "OH",
            "license": "RN194973",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "OH",
            "license": "RN194973",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "OH",
            "license": "RN 194973",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2171582",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mandy Goodman, SWT
• Kelly Lynn Goodrick, LPN
• Carina Gordon
• Eileen Kilbane Gordon, PNP
• Jessica R Gordon, LSW
• Michael Louis Gorjanc, MD
• Katherine Gorjup
• Candice Goykhberg, LPCC, LICDC
• Kelly Grace, RN
• Anthony Graham, LPC

• Cardiac Rehabilitation Registered Nurse in Mentor, OH
• Providers in Mentor, OH by specialty
• Cardiac Rehabilitation Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.