Gordon Bernell Charter School

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

GORDON BERNELL CHARTER SCHOOL

Practice address

2821 4TH St NW
Albuquerque, NM 87107-1313

Phone

(505) 916-8618

Fax

(505) 208-7880

NPI assigned

Oct 2, 2019

Last updated

Oct 2, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michelle Renee Gentry

Title

Credentialing Specialist

Phone

(800) 354-4881

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569974400000",
    "number": "1174164974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 N CENTRAL AVE STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121950",
            "telephone_number": "800-354-4881",
            "fax_number": "602-926-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 4TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871071313",
            "telephone_number": "505-916-8618",
            "fax_number": "505-208-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON BERNELL CHARTER SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A",
        "authorized_official_last_name": "GENTRY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "800-354-4881"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Jane Gorab, PA
• Ruthann Goradia
• Cynthia Goranson, HAD
• Sarah Gorder, D.O.M.
• Genesis Linda Gordiano
• Allison Gordon
• Amy Elisabeth Gordon, LPCC
• Angelia Denise Gordon
• Bosha A Gordon, APRN
• Brittany Dawn Gordon, LAMFT, LMHC

• Local Education Agency (LEA) in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Local Education Agency (LEA) in New Mexico

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