Kerry Gordon, MS, ATC, CSCS

Primary specialty

SpecialistTaxonomy code 174400000X

License

0506182 Issued in NV

Practice address

980 Kelly Johnson Dr
Suite 200
Las Vegas, NV 89119-3785

Phone

(702) 205-1315

NPI assigned

Oct 24, 2007

Last updated

Apr 23, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1639358831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6775 EDMOND ST STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183502",
            "telephone_number": "702-205-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 KELLY JOHNSON DR",
            "address_2": "SUITE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891193785",
            "telephone_number": "702-205-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KERRY",
        "credential": "MS, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-24",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "660",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "0506182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Gordon
• Jason Alexander Gordon
• Jessica Gordon, MD
• Julie Meredith Gordon
• Karen Gordon
• Linda Gordon
• Maleeya Leenae Gordon
• Margaret Mary Gordon, PHARM.D.
• Markesha Gordon
• Melissa Gordon

• Specialist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Specialist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.