Individual provider Active NPI

Lisa Gordon, FNP

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1497187744
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18441 Issued in SC
Practice address
1601 Greene St
Columbia, SC 29208-4001
Phone
(803) 777-7412
NPI assigned
Aug 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18441 SC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1601 Greene St
Columbia, SC 29208-4001

Mailing address

1601 Greene St
Columbia, SC 29208-4001
Phone (803) 777-7412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131011001474 SC Practitioner - Nurse Practitioner 8820222516 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Regional Medical Center of Orangeburg and Calhoun Counties Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties CurrentSince Sep 2, 2013 Accepting new patients
The Regional Medical Center of Orangeburg and Calhoun Counties CurrentSince Sep 2, 2013 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Sep 6, 2016 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Sep 6, 2016 Accepting new patients

Locations

220 Faison Dr
Columbia, SC 29203
Phone (803) 898-1662

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

1097B Cook Rd
Orangeburg, SC 29118
Phone (803) 534-5110

1175 Cook Rd
Ste 230
Orangeburg, SC 29118
Phone (803) 395-3844

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1497187744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 GREENE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292084001",
            "telephone_number": "803-777-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 GREENE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292084001",
            "telephone_number": "803-777-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "LISA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18441",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.