Individual provider Active NPI

Francine Gordon

  • Clinical Social Worker
  • Douglasville, GA
National Provider Identifier
1679980395
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
12461 Veterans Memorial Hwy, Suite # 631
Douglasville, GA 30134-2025
Phone
(770) 415-3601
Fax
(678) 534-8986
NPI assigned
Jul 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X GA Primary

Addresses

Primary practice location

12461 Veterans Memorial Hwy, Suite # 631
Douglasville, GA 30134-2025

Mailing address

6000 Stewart Pkwy Unit 6271
Douglasville, GA 30154-1114
Phone (770) 415-3601

Other practice location 1

6000 Stewart Pkwy Unit 6271
Douglasville, GA 30154-1114
Phone (770) 415-3601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Traumcore Clinical CurrentSince Jan 10, 2021 Accepting new patients

Locations

6000 Stewart Pkwy
Unit 6271
Douglasville, GA 30154
Phone (770) 415-3601

12461 Veterans Memorial Hwy
Ste 631
Douglasville, GA 30134
Phone (770) 415-3601

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1679980395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 STEWART PKWY UNIT 6271",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301541114",
            "telephone_number": "770-415-3601",
            "fax_number": "678-534-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12461 VETERANS MEMORIAL HWY, SUITE # 631",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342025",
            "telephone_number": "770-415-3601",
            "fax_number": "678-534-8986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6000 Stewart Pkwy Unit 6271",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301541114",
            "country_code": "US",
            "telephone_number": "770-415-3601",
            "fax_number": "678-534-8986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "FRANCINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.