Marilyn S Gordon, LD/N

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND243 Issued in FL

Practice address

3200 S University Dr
Davie, FL 33328-2018

Phone

(954) 262-4055

Fax

(954) 262-3815

NPI assigned

Feb 4, 2008

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Nova Southeastern University, Inc

  • Optometrist
  • Fort Lauderdale, FL
  • NPI 1700924511
  Medicare reassignment NPD
• Nova Southeastern University, Inc

  • Optometrist
  • North Miami Beach, FL
  • NPI 1225277650
  NPD
• Nova Southeastern University, Inc

  • Family Medicine Physician
  • Davie, FL
  • NPI 1447345517

  Nutritionist

  NPD (past)
• Nova Southeastern University, Inc

  • Family Medicine Physician
  • Davie, FL
  • NPI 1922603422
  NPD (past)

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1679751556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "address_2": "ASSEMBLY BLDG. # 2 ROOM 202",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4343",
            "fax_number": "954-262-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4055",
            "fax_number": "954-262-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MARILYN",
        "middle_name": "S",
        "credential": "LD/N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "ND243",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://login.intelichart/NSUHealthClinics/",
            "affiliation": "N",
            "address_1": "3200 S University Dr",
            "city": "Davie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333282018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angela S Goodrich, M.S., BCBA
• Alexandra Goodsite
• Andrea Goolab, LMHC
• Lorraine Gooze, RRT
• Danielle Marie Gordon, M.S., BCBA
• Sheryl Denise Gordon, ED.D
• Ann Gossy
• Anton Samuel Gotlieb, DDS
• Karah Gottschalk, AU.D.
• Ange Gouraige

• Registered Dietitian in Davie, FL
• Providers in Davie, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.