Jeremy M Gordon DC PA

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

CH7770 Issued in FL

Legal business name

JEREMY M GORDON DC PA

Practice address

905 N Stone St
Deland, FL 32720-2521

Phone

(386) 734-9995

Fax

(386) 734-9949

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy M Gordon, DCNPI 1144217480

Title

President

Phone

(386) 734-9995

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy Michael Gordon, D.C.

  • Chiropractor
  • Deland, FL
  • NPI 1144217480
  Medicare reassignment Care Compare group NPD Authorized official
• John Damrath, DC

  • Chiropractor
  • Deland, FL
  • NPI 1447901574
  Medicare reassignment Care Compare group NPD
• Jason Thomas Job, D.C.

  • Chiropractor
  • Deland, FL
  • NPI 1104367457
  Medicare reassignment Care Compare group NPD
• Michael Munson, D.C.

  • Chiropractor
  • Deland, FL
  • NPI 1871935502
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1669562500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-734-9995",
            "fax_number": "386-734-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-734-9995",
            "fax_number": "386-734-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY M GORDON DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-734-9995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "CH7770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "55875",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chesnel Jean-Mary, RPH
• Jeanette S. Jacobs, Psy.D.
• Alyssa Rupp Jefferson, LCSW
• Jeffrey L Timko OD PA
• Holly June Jeffrey, L.P.N.
• Jesnasublett, PLLC
• Jill Sheldon Counseling LLC
• Maydelin Jimenez
• Jason Thomas Job, D.C.
• John D. Gaffney, D. C., P. a.

• Multi-Specialty Clinic/Center in Deland, FL
• Providers in Deland, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.