Jan Marie Gordon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004719A Issued in IN

Practice address

10320 Ridge Line CT
Indianapolis, IN 46236-7738

Phone

(317) 823-8984

NPI assigned

Jan 18, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Talkspace Provider Network PAGroup PAC ID 5799136701, 249 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Talkspace Provider Network PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1639814049

  IN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1508330861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10320 RIDGE LINE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462367738",
            "telephone_number": "317-823-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 RIDGE LINE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462367738",
            "telephone_number": "317-823-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004719A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carvell Gordon Sr.
• Christopher Gordon, PHARMD
• Cynthia Amy Gordon
• David Michael Gordon, MD
• James Nathaniel Gordon, RADIATION THERAPIST
• Jessica A Gordon, LMFT
• Julie Brant Gordon, LCSW
• Kevin Ray Gordon, NP
• Susan Gordon, PHARM.D.
• Marcy Danielle Gordy, P.T., DPT

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.