Eileen Kilbane Gordon, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NPO2449 Issued in OH

Practice address

9000 Mentor Ave
100
Mentor, OH 44060-4496

Phone

(440) 974-4470

Fax

(440) 974-4173

NPI assigned

Nov 22, 2006

Last updated

Jul 7, 2011By 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 names 1

• Mrs. Eileen Kilbane Gordon Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1275608200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 MENTOR AVE",
            "address_2": "100",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "44060",
            "telephone_number": "440-974-4470",
            "fax_number": "440-974-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 MENTOR AVE",
            "address_2": "100",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604496",
            "telephone_number": "440-974-4470",
            "fax_number": "440-974-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "EILEEN",
        "middle_name": "KILBANE",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "NPO2449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EILEEN",
            "last_name": "GORDON",
            "middle_name": "KILBANE",
            "prefix": "MRS.",
            "credential": "PNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shanecia S Golston, QMHS
• Carmen T Gomez-Jeffrey, MA, LPCC-ATR
• Mandy Goodman, SWT
• Kelly Lynn Goodrick, LPN
• Carina Gordon
• Jessica R Gordon, LSW
• Shirley Gordon, RN
• Michael Louis Gorjanc, MD
• Katherine Gorjup
• Candice Goykhberg, LPCC, LICDC

• Pediatric Nurse Practitioner in Mentor, OH
• Providers in Mentor, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.