Individual provider Active NPI

Jessica Gordon Gordon Thompson

  • Registered Nurse
  • Orlando, FL
National Provider Identifier
1174116818
Registry record updated Feb 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9416590 Issued in FL
Practice address
7915 Tanbier Dr
Orlando, FL 32818-8746
Phone
(140) 748-6075
NPI assigned
Feb 13, 2021
Last updated
Feb 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9416590 FL Primary

Addresses

Primary practice location

7915 Tanbier Dr
Orlando, FL 32818-8746

Mailing address

4786 Piedmont CT
Orlando, FL 32811-4306
Phone (407) 486-0758

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
RN9416590FLMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1613174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1174116818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4786 PIEDMONT CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328114306",
            "telephone_number": "407-486-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7915 TANBIER DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328188746",
            "telephone_number": "140-748-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON THOMPSON",
        "first_name": "JESSICA",
        "middle_name": "GORDON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-13",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9416590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2021; 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.