Active NPI
Nancy H Gordon, MA, CCC-SLP
- Speech-Language Pathologist
- Leesburg, VA
National Provider Identifier
1780698589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202002705
- Practice address
- 906 Trailview Blvd SE
Suite a
Leesburg, VA 20175-4415 - Phone
- (703) 777-0561
- Fax
- (703) 737-8235
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202002705 | VA | Primary |
Addresses
Primary practice location
906 Trailview Blvd SE
Suite a
Leesburg, VA 20175-4415
Mailing address
906 Trailview Blvd. SE
Suite a
Leesburg, VA 20175
Phone (703) 777-0561
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 257110 | Other | VA | MAMSI |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2202002705 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189555200000",
"number": "1780698589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "906 TRAILVIEW BLVD. SE",
"address_2": "SUITE A",
"city": "LEESBURG",
"state": "VA",
"postal_code": "20175",
"telephone_number": "703-777-0561",
"fax_number": "703-737-8235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "906 TRAILVIEW BLVD SE",
"address_2": "SUITE A",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201754415",
"telephone_number": "703-777-0561",
"fax_number": "703-737-8235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "NANCY",
"middle_name": "H",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2007-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202002705",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "257110",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.