Jenna T Gordon, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

25416 Issued in SC

Practice address

14866 Ocean Hwy
Pawleys Island, SC 29585-4801

Phone

(843) 900-0777

Fax

(843) 900-0780

NPI assigned

Feb 7, 2022

Last updated

Feb 28, 2022By 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

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medicos, P.a.

  • Internal Medicine Physician
  • North Myrtle Beach, SC
  • NPI 1548024540
  Medicare reassignment NPD
• Vesna Solheim, MD PC

  dba Solheim Family Medicine

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1699145524
  Medicare reassignment NPD
• Physicians at Home PC

  • Internal Medicine Physician
  • Myrtle Beach, SC
  • NPI 1487073193
  NPD (past)

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1376297630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14866 OCEAN HWY",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295854801",
            "telephone_number": "843-900-0777",
            "fax_number": "843-900-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14866 OCEAN HWY",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295854801",
            "telephone_number": "843-900-0777",
            "fax_number": "843-900-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JENNA",
        "middle_name": "T",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "25416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Jean Glazier, PTA
• Dioselina Ruiz Godbold, MA, LPCI, CT
• Good Therapy
• Rhonda Goodale
• Goodwill Transportation Services SC LLC
• David Edwin Grabeman, D.D.S.
• Carla Stahl Graham, NP-C
• Michael Maxwell Grant, PH.D.
• Patricia R Grant, M.D.
• Lynda Lou Grinnen, PTA

• Family Nurse Practitioner in Pawley's Island, SC
• Providers in Pawley's Island, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.