Kelly Marie Gordon, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11007511 Issued in FL

Practice address

10220 Yale Ave
Weeki Wachee, FL 34613-8375

Phone

(352) 600-8822

Fax

(352) 600-8883

NPI assigned

Jun 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, CO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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

• All Family Walk-in Clinic LLC

  • Family Nurse Practitioner
  • Weeki Wachee, FL
  • NPI 1558948455
  Medicare reassignment NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  CO, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• All Family Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Weeki Wachee, FL
  • NPI 1548972771
  Medicare reassignment NPD
• Simon Groseclose DC LLC

  • Internal Medicine Physician
  • Wesley Chapel, FL
  • NPI 1275073710
  Medicare reassignment NPD
• Total Care Plus LLC

  • Urgent Care Clinic/Center
  • Brooksville, FL
  • NPI 1376069948
  Medicare reassignment NPD
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1194349019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 YALE AVE",
            "city": "WEEKI WACHEE",
            "state": "FL",
            "postal_code": "346138375",
            "telephone_number": "352-600-8822",
            "fax_number": "352-600-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10220 YALE AVE",
            "city": "WEEKI WACHEE",
            "state": "FL",
            "postal_code": "346138375",
            "telephone_number": "352-600-8822",
            "fax_number": "352-600-8883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166711",
            "country_code": "US",
            "telephone_number": "352-600-8822",
            "fax_number": "352-600-8883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Alaskan Way S Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042785",
            "country_code": "US",
            "telephone_number": "360-358-7833",
            "fax_number": "352-600-8883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 S Tejon St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809032253",
            "country_code": "US",
            "telephone_number": "352-600-8822",
            "fax_number": "352-600-8883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "ARNP.AP.70130802-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11007511",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-RXN.0103332-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11007511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Joseph Flaig III, PHARMD
• Kimberly Fleming, PTA
• Freedom Naturally LLC
• Patrick Furlong, MA
• Trevor Gregory Gamble, DC
• Stanley F Gould, M.D.
• Veronika Grafski
• Susanne Lise Graham, LMHC
• Tristan Graham, APRN
• Anthony Grossi, DC

• Psychiatric/Mental Health Nurse Practitioner in Weeki Wachee, FL
• Providers in Weeki Wachee, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.