Active NPI
Edward Gordon Jr.
- Attendant Care Provider
- Tallahassee, FL
National Provider Identifier
1386278596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- Practice address
- 2472 Chateau LN
Tallahassee, FL 32311-5604 - Phone
- (850) 896-4709
- NPI assigned
- Feb 26, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Primary |
Addresses
Primary practice location
2472 Chateau LN
Tallahassee, FL 32311-5604
Mailing address
115 S Pinetree Blvd Apt 1205
BLDG 12
Thomasville, GA 31792-7175
Phone (229) 221-5073
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582675200000",
"number": "1386278596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 S PINETREE BLVD APT 1205",
"address_2": "BLDG 12",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317927175",
"telephone_number": "229-221-5073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2472 CHATEAU LN",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323115604",
"telephone_number": "850-896-4709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "EDWARD",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-26",
"last_updated": "2020-02-26",
"certification_date": "2020-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.