Shelley Marie Gordon

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9279224 Issued in FL

Practice address

6000 Ellenor Dr.
Orlando, FL 32809

Phone

(407) 613-5555

NPI assigned

Dec 27, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1235645276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5612 ESCALANTE CANYON DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347581729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 ELLENOR DR.",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32809",
            "telephone_number": "407-613-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SHELLEY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-27",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2019081903",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9279224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Gordon
• Paul R. Gordon, MD
• Paulette Gordon, ARNP
• Regine Gordon
• Sarah Army Gordon, P.A.
• Tennille Gordon
• Toni-Anne T Gordon, DMD
• Travis Gordon, DO
• Yashima Yeshiva, Yasheba Gordon, RBT-22-229290
• Yvonne Patricia Gordon

• Family Nurse Practitioner in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.