Jessica E Gordon, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

19821 Issued in MS

Practice address

5000 Highway 39 N
Meridian, MS 39301

Phone

(601) 483-6211

Fax

(601) 482-3263

NPI assigned

May 21, 2007

Last updated

Jul 28, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• TBD Acquisition II LLC

  dba Gulfport Behavioral Health System

  • Psychiatric Hospital
  • Gulfport, MS
  • NPI 1750891792
  Medicare reassignment NPD
• TBD Acquisition II, LLC

  dba Gulfport Behavioral Health System

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1003324419
  NPD
• Alliance Health Center Inc

  • Psychiatric Hospital
  • Meridian, MS
  • NPI 1831184951
  NPD (past)
• Brentwood Acquisition Inc

  • Psychiatric Hospital
  • Flowood, MS
  • NPI 1487638441
  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1215145222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 HIGHWAY 39 N",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "39301",
            "telephone_number": "601-483-6211",
            "fax_number": "601-482-3623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HIGHWAY 39 N",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "39301",
            "telephone_number": "601-483-6211",
            "fax_number": "601-482-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JESSICA",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "19821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06527227",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Perry Jay Goodman, M.D.
• Andrea D. Goodwin, M.D.
• Aurthur Goodwin, LPC
• Nekesha Johnnyette Gordon Crowell
• Gary G. Gordon, D.O.
• Andrea Gore
• Troy Eugene Gore, RPA
• Cameron Goss
• Andrew Gowdey, M.D
• Dorothy Gowdy

• Psychiatry Physician in Meridian, MS
• Providers in Meridian, MS by specialty
• Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.