Active NPI
Lauren Gordon, CPNP
- Pediatric Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 2003017774
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104-1003 - Phone
- (314) 577-5666
- NPI assigned
- Apr 23, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 2003017774 | MO | Primary |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Mailing address
3247 Geyer Ave
Saint Louis, MO 63104-1520
Phone (314) 258-4318
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lgordon15887@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003017774 | MO | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care St. Louis | Current | Accepting new patients | |
| SSM Health Care St Louis | Current | Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
13000 Butler Crest Dr
Saint Louis, MO 63128
Phone (314) 842-3535
3878 Pershall Rd
Saint Louis, MO 63135
Phone (314) 344-6021
1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189
Interoperability endpoints
- lgordon15887@direct-ehr-ssmhc.com
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Fenton, MO
- NPI 1275586174
-
- Emergency Medicine Physician
- Saint Louis, MO
- NPI 1366400855
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604361600000",
"number": "1679717417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3247 GEYER AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041520",
"telephone_number": "314-258-4318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "314-577-5666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LAUREN",
"credential": "CPNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-23",
"last_updated": "2020-11-03",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MO",
"license": "2003017774",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lgordon15887@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "lgordon15887@direct-ehr-ssmhc.com",
"address_1": "1465 S Grand Blvd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631041003",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "1465 S Grand Blvd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631041003",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.