Debra Lynne Gordon, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Weed, CA
NPI 1497810592 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1497810592
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- NP 14966 (CA)
- Practice address
- 16337 Everhart Dr
Weed, CA 96094 - Phone
- (530) 938-2297
- Fax
- (530) 938-0494
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190124002020 | CA | Order and Referring Only - Nurse Practitioner | 4486892437 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63273 | CA | MD | Mental Health Counselor |
| 14996 | CA | MD | Physician Assistant |
| NP 14966 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Feather River Hospital | Past | Accepting new patients | |
| Feather River Hospital | Past |
Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 14996 | CA | |
| Family Nurse Practitioner | 363LF0000X | NP 14966 | CA | Yes |
Addresses
Primary practice location
16337 Everhart Dr
Weed, CA 96094
Mailing address
16337 Everhart Dr
Weed, CA 96094-9400
Phone (530) 938-2297
Other practice location 1
5125 Skyway
Paradise, CA 95969-5624
Phone (530) 872-2000
Other practice location 2
4625 Solus Dr
Weed, CA 96094-9736
Phone (530) 521-1257
Other providers in Weed, CA
- Geno Lowell Depaoli
- Dignity Health
- Scott F Durbin
- DWM Ventures LLC
- Alicia Gonzalez
- Vivian Hartz
- Heal Experiential LLC
- Health Quest Physical Therapy & Fitness Center, Inc.
- Monica Highfill
- Rebekah Hopkins
All providers in Weed, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.