Vanessa D Gorham

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

License

24-016822-1 Issued in IN

Practice address

5335 N Tacoma Ave Ste 13
Indianapolis, IN 46220-3648

Phone

(317) 360-2421

NPI assigned

May 31, 2024

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• 360 Home Care Services LLC

  • Attendant Care Provider
  • Indianapolis, IN
  • NPI 1467295428
  NPD Authorized official
• The 360 Phlebotomy LLC

  • Health Service Clinic/Center
  • Indianapolis, IN
  • NPI 1962247767
  NPD Authorized official

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1821838251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11653 STOEPPELWERTH DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462294244",
            "telephone_number": "317-360-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5335 N TACOMA AVE STE 13",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203648",
            "telephone_number": "317-360-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORHAM",
        "first_name": "VANESSA",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "IN",
            "license": "24-016822-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haleigh Gore, RBT
• Joshua Joseph Gore, MSW, LCSW
• Leonid Gorelik, MD
• Kathryn M Gorenflo, APRN FNP-BC
• Mary B. Gorgol, M.A. CCC-SLP
• Jessica Gayle Gorka, RN
• Colleen Gorkis-Jones, DPT
• Corrina Marie Gorman, RBT
• Kimberly S. Gorman, PH.D.
• Lawrence Gorman III, CHW-CRS, CPSP

• Attendant Care Provider in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Attendant Care Provider in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.