Individual provider Active NPI

Makala A Gordon

  • Pediatric Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1508529967
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
34974 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-0005
Phone
(615) 322-5000
NPI assigned
Oct 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 227921 TN
Nurse Practitioner 363L00000X 34974 TN
Pediatric Nurse Practitioner 363LP0200X 34974 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-0005

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691

Other practice location 1

2200 Childrens Way
Nashville, TN 37232-0005
Phone (615) 936-4009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241229000018 TN Practitioner - Nurse Practitioner 2264969492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
227921TNMDRegistered Nurse
34974TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center CurrentSince Dec 1, 2024 Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

2200 Childrens Way
Nashville, TN 37232
Phone (615) 322-3023

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

1301 Medical Center Dr
Nashville, TN 37232
Phone (615) 343-4882

Interoperability endpoints

  • Direct secure messaging: mgordon394322@direct.vumc.org

Organizations & group practices 1

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": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1508529967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372320005",
            "telephone_number": "615-322-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372320005",
            "country_code": "US",
            "telephone_number": "615-936-4009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MAKALA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "227921",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "34974",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "34974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.