Individual provider Active NPI

Gerlinda Marie Gordon

  • Family Nurse Practitioner
  • Roseville, MI
National Provider Identifier
1710460282
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F08180738 Issued in MI
Practice address
28811 Felician St
Roseville, MI 48066-7442
Phone
(248) 910-0206
NPI assigned
Sep 11, 2018
Last updated
Sep 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F08180738 MI Primary

Addresses

Primary practice location

28811 Felician St
Roseville, MI 48066-7442

Mailing address

28811 Felician St
Roseville, MI 48066-7442
Phone (248) 910-0206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190305002823 MI Practitioner - Nurse Practitioner 6103165360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Michigan State University College of Human Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Clair Specialty Physicians PCGroup PAC ID 6204733256, 36 clinicians

Practice addresses (Care Compare)

18001 E 10 Mile Rd
Roseville, MI 48066-3803
Phone (586) 871-3686

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F08180738MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Clair Specialty Physicians PC CurrentSince Jun 3, 2019 Accepting new patients

Locations

18001 E 10 Mile Rd
Roseville, MI 48066
Phone (586) 218-5800

23857 Greenfield Rd
Southfield, MI 48075
Phone (248) 569-6111

45640 Schoenherr Rd
Ste B
Utica, MI 48315
Phone (586) 247-4300

Interoperability endpoints

  • Direct secure messaging: gerlindagordon@stclairspe.allscriptsdirect.net
  • Direct secure messaging: ggordon58341@direct.hfhs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1710460282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28811 FELICIAN ST",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480667442",
            "telephone_number": "248-910-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28811 FELICIAN ST",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480667442",
            "telephone_number": "248-910-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GERLINDA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F08180738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

Verify at the official NPI Registry.