Organization Active NPI

Christine Gordon LLC

Doing business as Gordon Chiropractic Family Health & Wellness Center

  • Chiropractor
  • Terre Haute, IN
National Provider Identifier
1396062980
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002232A Issued in IN
Legal business name
CHRISTINE GORDON LLC
Doing business as
Gordon Chiropractic Family Health & Wellness Center
Practice address
3212 N 13TH St
Terre Haute, IN 47804-1236
Phone
(812) 460-1400
Fax
(812) 460-1400
NPI assigned
Apr 23, 2010
Last updated
Jan 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Dr. Christine M Gordon, DCNPI 1487606158
Title
Owener/Chiropractor
Phone
(812) 460-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002232A IN Primary

Addresses

Primary practice location

3212 N 13TH St
Terre Haute, IN 47804-1236

Mailing address

3212 N 13TH Street
Terre Haute, IN 47804-1236
Phone (812) 460-1400

Other identifiers 1

IdentifierTypeStateIssuer
200543520MedicaidIN

Other names 1

  • Gordon Chiropractic Family Health & Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100610001085 IN Part B Supplier - Clinic/Group Practice 7517097900 Receives reassigned benefits from 1 practitioner
Practice locations: Terre Haute, IN

National Provider Directory

National Provider Directory

Locations

3206 N 13th St
Terre Haute, IN 47804
Phone (812) 917-4164

3212 N 13th St
Terre Haute, IN 47804
Phone (812) 460-1400

Practitioners & affiliated clinicians

Practitioners 7

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": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1396062980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 N 13TH STREET",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478041236",
            "telephone_number": "812-460-1400",
            "fax_number": "812-460-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 N 13TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478041236",
            "telephone_number": "812-460-1400",
            "fax_number": "812-460-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE GORDON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWENER/CHIROPRACTOR",
        "authorized_official_telephone_number": "812-460-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002232A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200543520",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gordon Chiropractic Family Health & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.