Brian Heath Gordon, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

48839 Issued in MS

Practice address

357 Towne Center Blvd Ste 403
Ridgeland, MS 39157-4844

Phone

(601) 869-5898

Fax

(601) 589-0825

NPI assigned

Mar 29, 2010

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 MS

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

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Killebrew Psychological Services LLCGroup PAC ID 8426330226, 15 clinicians

Neurocognitive Specialty Group PLLCGroup PAC ID 9133451297, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Neurocognitive Specialty Group, PLLC

  • Clinical Neuropsychologist
  • League City, TX
  • NPI 1346700275

  MS

  Medicare reassignment Care Compare group NPD
• Killebrew Psychological Services, LLC

  • Psychologist
  • Ridgeland, MS
  • NPI 1073988051
  Medicare reassignment Care Compare group
• Covington County Hospital

  • Psychiatric Hospital Unit
  • Collins, MS
  • NPI 1225150436
  Medicare reassignment NPD

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1871818369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2427",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391302427",
            "telephone_number": "601-869-5898",
            "fax_number": "601-589-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 TOWNE CENTER BLVD STE 403",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574844",
            "telephone_number": "601-869-5898",
            "fax_number": "601-589-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "BRIAN",
        "middle_name": "HEATH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MS",
            "license": "48839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Patrice Golden
• Emily McDill Gonseth
• Jordyn Baleigh Gooch, OTR/L
• Monique Gooden, FNP-C
• Diane V. Goodloe, OT
• Courtney Rae Gordon, NP
• Phoebe Gordon, MT
• Bethany Harrelson Gough, MS CCC-SLP
• Gptrs II (Genesis Physical Therapy and Rehabilitation Services LLC)
• Gptrs II (Genesis Physical Therapy and Rehabilitation Services)

• Clinical Neuropsychologist in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Clinical Neuropsychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.