Active NPI
James Antonio Gordon, PH.D
- Pastoral Counselor
- Saint Albans, NY
National Provider Identifier
1376945915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- JG719654D
- Practice address
- 11341 Farmers Blvd
Saint Albans, NY 11412-2425 - Phone
- (914) 258-7547
- NPI assigned
- Sep 25, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | JG719654D | MS | Primary |
| Pastoral Counselor | 101YP1600X | JG71501X | MS |
Addresses
Primary practice location
11341 Farmers Blvd
Saint Albans, NY 11412-2425
Mailing address
11341 Farmers Blvd
Saint Albans, NY 11412-2425
Phone (914) 258-7547
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JG71501X | MS | MD | Pastoral Counselor |
| JG719654D | MS | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411603200000",
"number": "1376945915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11341 FARMERS BLVD",
"city": "SAINT ALBANS",
"state": "NY",
"postal_code": "114122425",
"telephone_number": "914-258-7547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11341 FARMERS BLVD",
"city": "SAINT ALBANS",
"state": "NY",
"postal_code": "114122425",
"telephone_number": "914-258-7547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "JAMES",
"middle_name": "ANTONIO",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-25",
"last_updated": "2014-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "MS",
"license": "JG719654D",
"primary": true
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "MS",
"license": "JG71501X",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Albans, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.