Katrena L Gordon, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

A004655 Issued in AR

Practice address

4301 W Markham St # 520-4
Little Rock, AR 72205-7101

Phone

(501) 686-6644

Fax

(501) 686-5725

NPI assigned

Feb 9, 2016

Last updated

Jun 21, 2022By 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 2

Addresses

Other names 1

• Katrena L Wilson Former name

Medicare fee-for-service enrollment

Enrolled in AR

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

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Arkansas Health Group

  dba Internal Medicine Associates of North Little Rock

  • Internal Medicine Physician
  • Maumelle, AR
  • NPI 1932118890
  Medicare reassignment NPD
• Baptist Health

  dba BMC Physician Clinic

  • Cardiovascular Disease Physician
  • Little Rock, AR
  • NPI 1578593067
  Medicare reassignment NPD
• Southeast Arkansas Hospitalists, LLP

  • Hospitalist Physician
  • Pine Bluff, AR
  • NPI 1912374018
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • Pine Bluff, AR
  • NPI 1831144120
  Medicare reassignment NPD
• Arkansas Health Group

  dba Baptist Health Surgical Clinic-Stuttgart

  • Surgery Physician
  • Stuttgart, AR
  • NPI 1952840555
  NPD
• Baptist Health

  dba BH Cancer Center - Heber Springs

  • Multi-Specialty Clinic/Center
  • Heber Springs, AR
  • NPI 1932081221
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• University of Arkansas for Medical Sciences

  • Durable Medical Equipment & Medical Supplies
  • Little Rock, AR
  • NPI 1275056004
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Arkansas for Medical Sciences

  dba The University Hospital of Arkansas

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1477549756
  Care Compare affiliation

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1952769614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 520-4",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-6644",
            "fax_number": "501-686-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KATRENA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-09",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A004655",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "A004655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRENA",
            "last_name": "WILSON",
            "middle_name": "L",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Varesh Gorabi
• Harmeen Goraya, M.D.
• Angela Denise Gordon, PHARM.D., BCPS
• Eric Houston Gordon, MD
• Jaclyn Gordon, DO
• Kori Raymer Gordon
• Mia Emily Gordon, LPC
• Otis T Gordon, M.D.
• Terry Arnette Gordon, DNP,APRN,AGACNP-BC
• Andrea Leigh Gore

• Gerontology Nurse Practitioner in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Gerontology Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.