Jeremy Michael Gordon, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH7770 Issued in FL

Practice address

905 N Stone St
Deland, FL 32720-2521

Phone

(386) 734-9995

Fax

(386) 734-9949

NPI assigned

Oct 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jeremy M Gordon DC PAGroup PAC ID 7911927041, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jeremy M Gordon DC PA

  • Multi-Specialty Clinic/Center
  • Deland, FL
  • NPI 1669562500
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1144217480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-734-9995",
            "fax_number": "386-734-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-734-9995",
            "fax_number": "386-734-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381193000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Golden, PHARMD
• Liliana Gomez
• William Gonzalez
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• Joseph Francis Goodreau, D.D.S.
• Victoria Gorelik, DDS
• Dianne Briggs Goshorn, M. ED., LMHC
• Gotlen Consulting LLC
• Michael S Grable, MD
• Grace Haven

• Chiropractor in Deland, FL
• Providers in Deland, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.