Jennifer Lee Gordon, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

57540 Issued in TN

Practice address

100 Brewster Blvd
Camp Lejeune, NC 28547

Phone

(910) 449-2778

Fax

(910) 450-4452

NPI assigned

Apr 18, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Tennessee, HSC, College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Augusta Surgical Group, P.C.Group PAC ID 9931488251, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Augusta Surgical Group, P.C.

  • Surgery Physician
  • Augusta, GA
  • NPI 1275626038
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University Health Services,Inc

  dba Piedmont Augusta Hospital

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1588665566
  Care Compare affiliation

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1598109811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "NMRTC OKINAWA, PSC 482, FPO AP 96362",
            "city": "FPO",
            "state": "AP",
            "postal_code": "96362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28547",
            "telephone_number": "910-449-2778",
            "fax_number": "910-450-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2022-05-13",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "57540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Anthony Gomperts
• Jasmine Bree Gonzales, DMD
• Charles Michael Goodman, MD
• Miranda Goodman, IDC
• Scott Michael Goodwin, DO
• Kent Gore
• Kepono Alvis Ross Gowan
• Emerson Franklin Gower
• Robert Brett Goy, D.O.
• John Carl Grady III, M.D.

• Surgery Physician in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; 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.