Active NPI
Dawn Gordon
- Pharmacy Technician
- Ponte Vedra Beach, FL
National Provider Identifier
1154427011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 270100103111816
- Practice address
- 290 Solana Rd
Ponte Vedra Beach, FL 32082-2234 - Phone
- (904) 543-8678
- Fax
- (904) 543-8606
- NPI assigned
- Sep 16, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 270100103111816 | FL | Primary |
Addresses
Primary practice location
290 Solana Rd
Ponte Vedra Beach, FL 32082-2234
Mailing address
938 4TH Ave S
Jacksonville Beach, FL 32250-4320
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 270100103111816 | FL | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154427011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "938 4TH AVE S",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322504320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 SOLANA RD",
"city": "PONTE VEDRA BEACH",
"state": "FL",
"postal_code": "320822234",
"telephone_number": "904-543-8678",
"fax_number": "904-543-8606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "DAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "FL",
"license": "270100103111816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponte Vedra Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.