Jeniyah Imani Gordon

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

125 Baldwin Ave
Charlotte, NC 28204-3364

Phone

(980) 423-1210

NPI assigned

Oct 28, 2025

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

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": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1083582225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6718 RUBIN LURA CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697375",
            "telephone_number": "704-606-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BALDWIN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043364",
            "telephone_number": "980-423-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JENIYAH",
        "middle_name": "IMANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coleen Gordon
• Dahlia K Gordon, MS, RD, LDN
• Damon L Gordon
• Eno Ekwere Gordon, PT
• Heidi Shamene Gordon, MSW
• Nakia S Gordon, PHD
• Sarah M. Gordon, LCSW
• Shayna Gordon
• Sherri L Gordon, PT
• Tyriss Iman Gordon, FNP

• Behavior Technician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Behavior Technician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.