Gail Gordon, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6206 Issued in MA

Practice address

9 Shalers Way
Chilmark, MA 02535

Phone

(508) 645-2040

NPI assigned

Aug 6, 2007

Last updated

Aug 6, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Martha's Vineyard Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Bluffs, MA
  • NPI 1659387074
  Medicare reassignment NPD

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1700077690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SHALERS WAY",
            "city": "CHILMARK",
            "state": "MA",
            "postal_code": "02535",
            "telephone_number": "508-645-2040",
            "fax_number": "508-645-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 SHALERS WAY",
            "city": "CHILMARK",
            "state": "MA",
            "postal_code": "02535",
            "telephone_number": "508-645-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "6206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NW05004",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harry F Beach
• Karen Thelma Cheshire, M.D.
• Elizabeth Gregg, MSW, LICSW
• Inner Journey Wellness PC
• Lifeguard Medical Group, LLC
• Linda S McCarthy, LMHC
• Thomas Redner, M.D.

• Clinical Psychologist in Chilmark, MA
• Providers in Chilmark, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.

Verify at the official NPI Registry.