Jordan Kugler Goranson

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2022-03329 Issued in NC

Practice address

Medical Center Boulevard
Winston Salem, NC 27157-0001

Phone

(336) 713-9100

NPI assigned

Mar 31, 2020

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 NC, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
• Atlantic General Hospital Hospital, Berlin, MD, CCN 210061
• University of Maryland Medical Center Hospital, Baltimore, MD, CCN 210002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735
  Medicare reassignment Care Compare group NPD
• Lifebrite Hospital Group of Stokes, LLC

  • Pediatrics Physician
  • Danbury, NC
  • NPI 1104369081
  Medicare reassignment NPD
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment NPD
• Lifebrite Hospital Group of Stokes, LLC

  • Rural Health Clinic/Center
  • Pine Hall, NC
  • NPI 1346775285
  NPD
• Lifebrite Hospital Group of Stokes, LLC

  • Critical Access Hospital
  • Danbury, NC
  • NPI 1841733714
  NPD
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tidalhealth Atlantic, Inc

  • General Acute Care Hospital
  • Berlin, MD
  • NPI 1053309120
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation
• University of Maryland Medical Center, LLC

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1174660120
  Care Compare affiliation

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1679101133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BOULEVARD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-713-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORANSON",
        "first_name": "JORDAN",
        "middle_name": "KUGLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2022-03329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sammie Jochum Goodwin, LPC, NCC, ATR-BC
• Goodworks Health Management, LLC
• Nakeyta Goolsby, PMHNP
• Suma Ramesh Gopal, M.D.
• Vineet Gopinathan, PHARMD
• Shireen A Goransson, RN
• Cierra Holly Gordon, MS, SLP
• Cortney Gordon
• Frances Friedensen Gordon, M.ED., LPC, LCAS
• Jonah Phillip Gordon

• Emergency Medicine Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.