Leteisha Mechi'Ell Gordon

Primary specialty

Vehicle Modifications ContractorTaxonomy code 171WV0202X

License

T63629900 Issued in VA

Practice address

1600 Presson Blvd
Richmond, VA 23224-8020

Phone

(804) 299-1932

NPI assigned

Jan 11, 2021

Last updated

Jan 11, 2021By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1528657905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7629",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232310129",
            "telephone_number": "804-299-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PRESSON BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232248020",
            "telephone_number": "804-299-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "LETEISHA",
        "middle_name": "MECHI'ELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WV0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Vehicle Modifications",
            "state": "VA",
            "license": "T63629900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMV LICENSE",
            "identifier": "T63629900",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "abdtyip@gmail.com",
            "affiliation": "N",
            "address_1": "1600 Presson Blvd",
            "city": "Richmond",
            "state": "VA",
            "country_code": "US",
            "postal_code": "232248020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina Beausoleil Gordon, DDS
• Derek Andrew Gordon
• Joshua Coleman Gordon, DDS
• Kenneth Bryce Gordon, OD
• Laura M Gordon, MD
• Martin Blackwell Gordon, LCSW
• Nakeisha Ann Gordon, LPC
• Robert Harrison Gordon Jr., LCSW, M.ED.
• Rose Cooper Gordon
• Sarah Wilema Gordon, D.O.

• Contractor in Richmond, VA
• Providers in Richmond, VA by specialty
• Contractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.