Active NPI
Tara Gordon
- School Counselor
- Memphis, TN
National Provider Identifier
1760937163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- License
- 000543136
- Practice address
- 2400 Union Ave
Suite 400
Memphis, TN 38112-4318 - Phone
- (662) 902-0391
- NPI assigned
- Aug 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 101YS0200X | 000543136 | TN | Primary |
Addresses
Primary practice location
2400 Union Ave
Suite 400
Memphis, TN 38112-4318
Mailing address
8577 S Trinity Park Dr
Olive Branch, MS 38654-6415
Phone (662) 902-0391
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000543136 | TN | MD | School Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471305600000",
"number": "1760937163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8577 S TRINITY PARK DR",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386546415",
"telephone_number": "662-902-0391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 UNION AVE",
"address_2": "SUITE 400",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381124318",
"telephone_number": "662-902-0391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "TARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-16",
"last_updated": "2016-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "TN",
"license": "000543136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.