Individual provider Active NPI

Melissa Gwyn Gordon, APRN

  • Family Nurse Practitioner
  • Griffin, GA
National Provider Identifier
1194595520
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP163255 Issued in GA
Practice address
1424 N Expressway Ste 121-123
Griffin, GA 30223-1753
Phone
(678) 688-2820
Fax
(770) 467-9868
NPI assigned
Jan 8, 2024
Last updated
Dec 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-NP163255 GA Primary

Addresses

Primary practice location

1424 N Expressway Ste 121-123
Griffin, GA 30223-1753

Mailing address

1424 N Expressway Ste 121-123
Griffin, GA 30223-1753
Phone (678) 688-2820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240123001657 GA Practitioner - Nurse Practitioner 1557713831 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP163255GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnect Health, Inc. CurrentSince Jan 17, 2024 Accepting new patients
Careconnect Health, Inc. CurrentSince Jan 17, 2024 Accepting new patients
Andrew T Mecca MD PC Family Medicine PastSince Jan 1, 2024 Accepting new patients
Andrew T Mecca Urgent Care LLC PastSince Jan 1, 2024 Accepting new patients

Locations

1424 N Expressway
Ste 121123
Griffin, GA 30223
Phone (678) 688-2820

510 Alston St
Ste B
Richland, GA 31825
Phone (229) 887-3324

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1194595520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 N EXPRESSWAY STE 121-123",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302231753",
            "telephone_number": "678-688-2820",
            "fax_number": "770-467-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 N EXPRESSWAY STE 121-123",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302231753",
            "telephone_number": "678-688-2820",
            "fax_number": "770-467-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MELISSA",
        "middle_name": "GWYN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP163255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.