Ariel Gordon

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

200 Capitol St Unit 1
Clinton, MS 39056-4026

Phone

(601) 925-3000

NPI assigned

Dec 18, 2023

Last updated

Dec 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Mississippi Medical College, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hurley Dermatology,PCGroup PAC ID 9335187889, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: agordon1@directaddress.net

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.

• Hurley Dermatology,PC

  • Specialist
  • West Chester, PA
  • NPI 1396943239
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1811765092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 P ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200011930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CAPITOL ST UNIT 1",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564026",
            "telephone_number": "601-925-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ARIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M Gibbs, DPT
• Karlyn Bren Goff, OTR/L
• Erica Goldsmith
• John Melvin Goolsby, D.M.D.
• John Melvin Goolsby Jr., DMD
• Maxie Lerone Gordon, MD
• Michael Deshuan Gordon, LPC
• Gptrs II (Genesis Physical Therapy and Rehabilitation Services)
• Grace and Mercy Personal Care and Respite Service, LLC
• William M Grantham, MD

• Physician Assistant in Clinton, MS
• Providers in Clinton, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.