Gina Gordenier

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

71015969A Issued in IN

Practice address

515 Park Place Cir Ste 200
Mishawaka, IN 46545-3585

Phone

(574) 607-4724

Fax

(574) 607-4725

NPI assigned

Oct 29, 2024

Last updated

Oct 29, 2024By 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

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kidney Care of Michiana LLCGroup PAC ID 7810149309, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ggordenier1146900@direct.trinity-health.org
• Direct secure messaging: ggordenier42134@direct.davitaphysiciansolutions.com
• FHIR API: https://api.platform.athenahealth.com/5893/brand/1/csg/1/fhir/r4

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.

• Kidney Care of Michiana LLC

  • Nephrology Physician
  • Mishawaka, IN
  • NPI 1093067530
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1659193928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PARK PLACE CIR STE 200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453585",
            "telephone_number": "574-607-4724",
            "fax_number": "574-607-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PARK PLACE CIR STE 200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453585",
            "telephone_number": "574-607-4724",
            "fax_number": "574-607-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDENIER",
        "first_name": "GINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71015969A",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71015969A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Goltowski, PT
• Francisco Javier Gomez-Dossi, M.D.
• Luis Felipe Gomez, M.D.
• Alyssa Joy Good
• Cory Goodson
• Amanda Gordillo, MA, RD, LD
• Aviva Gordon
• Heather Gordy, NP
• Emily Grace Gouker, PA-C
• Kayla Gowen

• Acute Care Nurse Practitioner in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Acute Care Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.