Janice Gordon
Individual provider Active NPI Contractor · Greenville, SC
NPI 1730728148 · NPPES record last updated Jan 8, 2020
Key facts
- NPI
- 1730728148
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 2020-34953 (SC)
- Practice address
- 1120 W Butler Rd Ste I
Greenville, SC 29607-4809 - Phone
- (864) 269-6985
- Fax
- (864) 751-1619
- NPI assigned
- Jan 2, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020-34953 | SC | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 2020-34953 | SC | Yes |
Addresses
Primary practice location
1120 W Butler Rd Ste I
Greenville, SC 29607-4809
Mailing address
1120 W Butler Rd Ste I
Greenville, SC 29607-4809
Phone (864) 269-6985
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 238290 | Other | NAICS | |
| 532283 | Other | NAICS | |
| 446119 | Other | NAICS | |
| 236118 | Other | NAICS | |
| 238990 | Other | NAICS | |
| 811198 | Other | NAICS | |
| 333921 | Other | NAICS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jgordon@101mobility.com |
Other providers in Greenville, SC
- Stephen Chas Goodwin
- Patricia Rogers Goodyear
- Paari Gopalakrishnan
- Olivia Gordon-Tomlinson
- Cynthia Gordon
- Kendra Talisha Gordon
- Syndey Gordon
- Michael Andrew Gore
- Barry R. Gorlitsky
- Gormley Clinic of Chiropractic LLC
All providers in Greenville, SC · Contractor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.