Balfour Anthony Gore

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

L8-0000205 Issued in DE

Practice address

100 Rockford Dr
Newark, DE 19713-2120

Phone

(302) 996-5480

NPI assigned

Apr 21, 2020

Last updated

Apr 21, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Banyan Delaware LLC

  dba Banyan Delaware

  • Substance Abuse Rehabilitation Facility
  • Milford, DE
  • NPI 1316579634
  NPD (past)

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1154941029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 RIVER RD APT 2",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198092402",
            "telephone_number": "302-384-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROCKFORD DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132120",
            "telephone_number": "302-996-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "BALFOUR",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0000205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon C Honig, DMD, PA
• Catherine Gordon
• Justeen Gordon
• Kate Gordon, CCC-SLP
• Amanda E Gordy, MSW
• Brian M Gorgoni, PA-C
• Joanne Goshow-Harris, D.O.
• Marisa Rachel Gossweiler, D.O.
• Jessica M. Gotay-Lehmer, DO
• Christina Marie Gotthold, ATC

• Psychiatric/Mental Health Nurse Practitioner in Newark, DE
• Providers in Newark, DE by specialty
• Psychiatric/Mental Health Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.