Active NPI
Octavia D Gordon
- Counselor
- Holyoke, MA
National Provider Identifier
1467066480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 80 Commercial St
Holyoke, MA 01040-4704 - Phone
- (413) 846-0445
- NPI assigned
- Sep 8, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
80 Commercial St
Holyoke, MA 01040-4704
Mailing address
147 Norman St
West Springfield, MA 01089-5003
Phone (413) 846-0445
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y10086 | Other | MA | MEDICARE |
| 1134107113 | Medicaid | MA |
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": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1467066480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 NORMAN ST",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "010895003",
"telephone_number": "413-846-0445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 COMMERCIAL ST",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "010404704",
"telephone_number": "413-846-0445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "OCTAVIA",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-08",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "Y10086",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1134107113",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Holyoke, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.