Nicole Angela Kelly-Gordon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-15933 Issued in AZ

Practice address

2920 N 4TH St
Flagstaff, AZ 86004-1816

Phone

(928) 853-2360

Fax

(928) 853-2360

NPI assigned

Mar 14, 2016

Last updated

Apr 20, 2026By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• El Rio Santa Cruz Neighborhood Health Center, Inc

  dba El Rio Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1487602736
  Medicare reassignment
• City of Hope Medical Group of Arizona LLC

  • Medical Oncology Physician
  • Goodyear, AZ
  • NPI 1609026806
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1073583472
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Show Low, AZ
  • NPI 1073740098
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Bullhead, AZ
  • NPI 1760798680
  NPD
• American Oncology Partners, P.a.

  dba Desert Hematology Oncology

  • Hematology & Oncology Physician
  • Surprise, AZ
  • NPI 1003642505
  NPD (past)
• Arizona Oncology Services Inc

  • Radiation Oncology Physician
  • Phoenix, AZ
  • NPI 1972628675
  NPD (past)

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1851752224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1231",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857021231",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 N 4TH ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041816",
            "telephone_number": "928-853-2360",
            "fax_number": "928-853-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY-GORDON",
        "first_name": "NICOLE",
        "middle_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-15933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123528",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Taylor Kellett, PA-C
• Judith Amanda Kelley, MD
• Ralph Zane Kelley, DO
• Star Kelley, LCSW
• Kelly Reber DPM, PC (Northern Arizona Podiatry Group)
• Melissa C Kelly, PHARMD
• Roger Casey Kelly
• Kelley Jeanine Kelson, RDN
• Eric Davis Kendle, M.D.
• Steven Homer Kendrick, PAS

• Clinical Social Worker in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.