Active NPI
Suzanne Lynn Gordon, MS, CCC-SLP
- Speech-Language Pathologist
- Albuquerque, NM
National Provider Identifier
1245308964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1301
- Practice address
- 1209 Monte Largo CT NE
Albuquerque, NM 87123-1826 - Phone
- (505) 385-4733
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1301 | NM | Primary |
Addresses
Primary practice location
1209 Monte Largo CT NE
Albuquerque, NM 87123-1826
Mailing address
11306 Richfield Ave NE
Albuquerque, NM 87122-4188
Phone (505) 385-4733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1301 | Other | NM | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1301 | NM | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245308964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11306 RICHFIELD AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871224188",
"telephone_number": "505-385-4733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1209 MONTE LARGO CT NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871231826",
"telephone_number": "505-385-4733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "SUZANNE",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "1301",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "1301",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.