Individual provider Active NPI

Lauren B. Gordon, WHNP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1669758900
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5024522 Issued in NC
Practice address
6324 Fairview Rd Ste 200
Charlotte, NC 28210-3361
Phone
(704) 316-6912
NPI assigned
Nov 1, 2011
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5024522 NC Primary
Advanced Practice Midwife 367A00000X RN1016727 DC

Addresses

Primary practice location

6324 Fairview Rd Ste 200
Charlotte, NC 28210-3361

Mailing address

6324 Fairview Rd Ste 200
Charlotte, NC 28210-3361
Phone (704) 316-6912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20170922000245 DC Practitioner - Certified Nurse Midwife (CNM) 2264706779 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN1016727DCMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom OB GYN, LLC CurrentSince Aug 1, 2017 Accepting new patients

Locations

4001 Brandywine St NW
Ste 300
Washington, DC 20016
Phone (202) 449-9570

Interoperability endpoints

  • Direct secure messaging: lauren.gordon.1@14179.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1669758900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103361",
            "telephone_number": "704-316-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103361",
            "telephone_number": "704-316-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "LAUREN",
        "middle_name": "B.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5024522",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "DC",
            "license": "RN1016727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.