Individual provider Active NPI

Cheryl Lynne Gordon, CPM, LM

  • Midwife
  • Mabank, TX
National Provider Identifier
1154870152
Registry record updated Oct 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
99277 Issued in TX
Practice address
101 Oak Dr
Mabank, TX 75156-7155
Phone
(254) 744-8634
NPI assigned
Oct 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 99277 TX Primary

Addresses

Primary practice location

101 Oak Dr
Mabank, TX 75156-7155

Mailing address

101 Oak Dr
Mabank, TX 75156-7155
Phone (254) 744-8634

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

LicenseStateTypeSpecialty
99277TXMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1475366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475366400000",
    "number": "1154870152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 OAK DR",
            "city": "MABANK",
            "state": "TX",
            "postal_code": "751567155",
            "telephone_number": "254-744-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OAK DR",
            "city": "MABANK",
            "state": "TX",
            "postal_code": "751567155",
            "telephone_number": "254-744-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CHERYL",
        "middle_name": "LYNNE",
        "credential": "CPM, LM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-02",
        "last_updated": "2016-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "TX",
            "license": "99277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mabank, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2016; 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.