Garry L Gordon II

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

0000084995 Issued in TN

Practice address

1797 Roane State Hwy
Harriman, TN 37748-8306

Phone

(865) 717-2835

NPI assigned

Nov 1, 2024

Last updated

Apr 9, 2026By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Walgreen Co

  dba Walgreens #10612

  • Pharmacy
  • Harriman, TN
  • NPI 1275731275
  NPD
• Walgreen Co

  dba Walgreens #21605

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1649093378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 VALLEY FORGE DR",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306671",
            "telephone_number": "865-466-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1797 ROANE STATE HWY",
            "city": "HARRIMAN",
            "state": "TN",
            "postal_code": "377488306",
            "telephone_number": "865-717-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GARRY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-01",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TN",
            "license": "0000084995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen May Gilliam, PMHNP-BC
• Bethanie Gilmore, RN
• Amanda L Godsey, PHARMD
• Jessica Jean Godsey, LPN
• Jill Kristina Goldston
• Corinna Fiona Graham, LPN
• Kristina M Graham, MA, NCC, LPC
• Jackie Lynn Greene-Gunter, OD
• Sarah C. Greene
• Doyle Alfred Griffis, D.PH.

• Psychiatric/Mental Health Registered Nurse in Harriman, TN
• Providers in Harriman, TN by specialty
• Psychiatric/Mental Health Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.