NPIMap

Individual provider Active NPI

Pamela L Gordon, CRNP

  • Family Nurse Practitioner
  • Hanover, PA
National Provider Identifier
1376996256
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP016307 Issued in PA
Practice address
848 Broadway
Hanover, PA 17331-2029
Phone
(717) 632-2700
Fax
(717) 632-1180
NPI assigned
Jul 15, 2016
Last updated
Jul 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP016307 PA Primary

Addresses

Primary practice location

848 Broadway
Hanover, PA 17331-2029

Mailing address

100 Penn St
Suite D
Hanover, PA 17331-1956
Phone (717) 632-0774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160913000046 PA Practitioner - Nurse Practitioner 6103112438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Hanover Family Practice Associates, LLCGroup PAC ID 1850299587, 15 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

848 Broadway
Hanover, PA 17331-2029
Phone (717) 632-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hanover Family Practice Associates, LLC CurrentSince Aug 15, 2016 Accepting new patients

Locations

100 Penn St
Ste D
Hanover, PA 17331
Phone (717) 632-0774

112 Clover Ln
Hanover, PA 17331
Phone (717) 632-4449

848 Broadway
Hanover, PA 17331
Phone (717) 632-0774

Interoperability endpoints

  • Direct secure messaging: pgordon445621@wellspan.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1376996256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PENN ST",
            "address_2": "SUITE D",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311956",
            "telephone_number": "717-632-0774",
            "fax_number": "717-633-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 BROADWAY",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173312029",
            "telephone_number": "717-632-2700",
            "fax_number": "717-632-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "PAMELA",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

Verify at the official NPI Registry.