NPIMap

Organization Active NPI

Gordon Private Care, LLC

  • In Home Supportive Care Agency
  • Saint Ann, MO
National Provider Identifier
1154965275
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
GORDON PRIVATE CARE, LLC
Practice address
11058 Florence Ave
Saint Ann, MO 63074-2119
Phone
(314) 780-1089
Fax
(866) 950-4040
NPI assigned
Oct 31, 2019
Last updated
Oct 31, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Authorized official

Name
Demeka Taylor-Gordon
Title
Member Manager
Phone
(314) 780-1089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

11058 Florence Ave
Saint Ann, MO 63074-2119

Mailing address

11058 Florence Ave
Saint Ann, MO 63074-2119
Phone (314) 780-1089

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1154965275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11058 FLORENCE AVE",
            "city": "SAINT ANN",
            "state": "MO",
            "postal_code": "630742119",
            "telephone_number": "314-780-1089",
            "fax_number": "866-950-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11058 FLORENCE AVE",
            "city": "SAINT ANN",
            "state": "MO",
            "postal_code": "630742119",
            "telephone_number": "314-780-1089",
            "fax_number": "866-950-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON PRIVATE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "TAYLOR-GORDON",
        "authorized_official_first_name": "DEMEKA",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "314-780-1089"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Ann, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.