Jessica Kayla Gordon, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

LL83656 Issued in SC

Practice address

50 E Hospital St Ste 3
Manning, SC 29102-3149

Phone

(803) 435-8828

NPI assigned

Mar 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034
• Baptist Beaumont Hospital Hospital, Beaumont, TX, CCN 450346

Merit-based Incentive Payment System (MIPS)

Final score

97.13 of 100Reported as apm

Quality

94.26

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgordon391778@christushealth.direct-ci.net

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.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment Care Compare group NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD

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

• Baptist Hospitals of Southeast Texas

  • General Acute Care Hospital
  • Beaumont, TX
  • NPI 1093744187
  Care Compare affiliation
• Christus Health Southeast Texas

  • General Acute Care Hospital
  • Beaumont, TX
  • NPI 1679557888
  Care Compare affiliation

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1750967378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E HOSPITAL ST STE 3",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023149",
            "telephone_number": "803-435-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E HOSPITAL ST STE 3",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023149",
            "telephone_number": "803-435-8828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 E Cheves St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295062617",
            "country_code": "US",
            "telephone_number": "843-777-2800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5875 N Major Dr",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777139034",
            "country_code": "US",
            "telephone_number": "409-892-2262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JESSICA",
        "middle_name": "KAYLA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V0405",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL83656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin James Gist II
• Jennifer L Glassey, DMD
• Charles E. Godwin III, NP
• Heather Johnson Goff, PTA
• Rashawnda S Gooden
• Caroline Coullette Grant, SAS
• Australia Van Dyke Greene, NP-C
• Jesse Meek Greene IV, CRNA
• Cozetta Grier
• Shannon V Griffin

• Family Medicine Physician in Manning, SC
• Providers in Manning, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.