Dominique McGordon

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

23-015658-1 Issued in IN

Practice address

4837 Oakbrook Dr
Indianapolis, IN 46254-1117

Phone

(317) 903-3007

Fax

(463) 900-1728

NPI assigned

Oct 10, 2023

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

State licenses

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 and National Provider Directory roles.

• Serenity Home Healthcare

  • Home Health Agency
  • Indianapolis, IN
  • NPI 1063233450
  NPD Authorized official
• Serenity Homecare LLC

  • In Home Supportive Care Agency
  • Indianapolis, IN
  • NPI 1184496986
  NPD Authorized official

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1336920867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4837 OAKBROOK DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462541117",
            "telephone_number": "317-903-3007",
            "fax_number": "463-900-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4837 OAKBROOK DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462541117",
            "telephone_number": "317-903-3007",
            "fax_number": "463-900-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGORDON",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "IN",
            "license": "23-015658-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Rose McGinty
• Deborah Ann McGlasson, NURSE PRACTITIONER
• Lara Ann McGlothlin
• John P McGoff, MD
• McGol Associates
• Anthony McGovern, MS, OTR
• Lisa Butterbaugh McGovern, MS, OTR
• Sherry McGowan, LCSW
• Jean E McGrady, MD
• Caitlin Anne McGrath, PA

• In Home Supportive Care Agency in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• In Home Supportive Care Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.