NPIMap

Organization Active NPI

Gordon Wellness LLC

  • Clinical Social Worker
  • Newport News, VA
National Provider Identifier
1376928101
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090400826 Issued in VA
Legal business name
GORDON WELLNESS LLC
Practice address
610 Thimble Shoals Blvd # 403
Newport News, VA 23606-2573
Phone
(757) 534-7840
Fax
(757) 506-0432
NPI assigned
Jul 22, 2015
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Mrs. Tonya Dorline Johnson, LCSWNPI 1750710232
Title
Owner
Phone
(757) 534-7840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 090400826 VA Primary

Addresses

Primary practice location

610 Thimble Shoals Blvd # 403
Newport News, VA 23606-2573

Mailing address

610 Thimble Shoals Blvd
401-A
Newport News, VA 23606-2573
Phone (757) 534-7840

National Provider Directory

National Provider Directory

Locations

610 Thimble Shoals Blvd
#403
Newport News, VA 23606
Phone (757) 534-7840

610 Thimble Shoals Blvd
Ste 401A
Newport News, VA 23606
Phone (757) 534-7840

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1376928101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 THIMBLE SHOALS BLVD",
            "address_2": "401-A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062573",
            "telephone_number": "757-534-7840",
            "fax_number": "757-534-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 THIMBLE SHOALS BLVD # 403",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062573",
            "telephone_number": "757-534-7840",
            "fax_number": "757-506-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "DORLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-534-7840",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "090400826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.