Active NPI
Lesley Ann Gordon
- Registered Nurse
- Tupelo, MS
National Provider Identifier
1487963054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R874445
- Practice address
- 607 Garfield St
Tupelo, MS 38801-6337 - Phone
- (662) 377-6290
- Fax
- (662) 377-6295
- NPI assigned
- Sep 30, 2010
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R874445 | MS | Primary |
Addresses
Primary practice location
607 Garfield St
Tupelo, MS 38801-6337
Mailing address
607 Garfield St
Tupelo, MS 38801-6337
Phone (662) 377-6290
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R874445 | MS | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285804800000",
"number": "1487963054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 GARFIELD ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388016337",
"telephone_number": "662-377-6290",
"fax_number": "662-377-6295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 GARFIELD ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388016337",
"telephone_number": "662-377-6290",
"fax_number": "662-377-6295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LESLEY",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-30",
"last_updated": "2010-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MS",
"license": "R874445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.