Kimberly Rochelle Gordon, SURGICAL ASSISTANT

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Practice address

3002 Gill St Ste 3
Bloomington, IL 61704-3438

Phone

(309) 846-4716

NPI assigned

May 14, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Definitive Neurodiagnostics LLC

  • Electroneurodiagnostic Specialist/Technologist
  • Normal, IL
  • NPI 1659490761
  NPD (past)
• Neuromonitoring Service LLC

  • Physical Medicine & Rehabilitation Physician
  • Normal, IL
  • NPI 1467583955
  NPD (past)

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1245407709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 RIVIERA DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017309",
            "telephone_number": "309-242-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 GILL ST STE 3",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043438",
            "telephone_number": "309-846-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KIMBERLY",
        "middle_name": "ROCHELLE",
        "name_prefix": "Mrs.",
        "credential": "SURGICAL ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Goodner
• Bailie Cole Goodrich
• Matthew Goodwin
• Chetna Vithal Gordhan, LCSW
• Aisha Lissette Gordon
• Christina Marie Gosteli
• Kandy L Goughnour
• Ashley Gould
• Bree Grabowski, PT
• Jaden Elizabeth Graham

• Surgical Assistant in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Surgical Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.