Kimberly Kristen Perry Gordon, M. ED., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP009722 Issued in GA

Practice address

173 Dogwood Hills Rd
Americus, GA 31709-5305

Phone

(229) 942-1304

NPI assigned

Sep 9, 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)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1922834852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 DOGWOOD HILLS RD",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317095305",
            "telephone_number": "229-942-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 DOGWOOD HILLS RD",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317095305",
            "telephone_number": "229-942-1304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5547 Veterans Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319044487",
            "country_code": "US",
            "telephone_number": "803-386-8623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KIMBERLY",
        "middle_name": "KRISTEN PERRY",
        "credential": "M. ED., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jalisa Givins
• Willie Goggins
• Miska Mycol Golphin-Phelps
• Margaret Mary Nalley Goodin, RD, LD
• Mary S Goodwyn
• Nichole Gordon, CNM, WHNP-BC
• Graceful Guardians Health Care LLC
• Graceful Hands Home Care LLC
• Leslie Green
• Sherita Patricia Green, LPN/RCIS

• Speech-Language Pathologist in Americus, GA
• Providers in Americus, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.