Amber Gordon, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202011078 Issued in VA

Practice address

19 Sanville School Rd
Bassett, VA 24055-5032

Phone

(276) 629-5301

NPI assigned

Jul 21, 2022

Last updated

Oct 2, 2023By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1972238137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 AUTUMN DR",
            "city": "COLLINSVILLE",
            "state": "VA",
            "postal_code": "240782623",
            "telephone_number": "276-734-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 SANVILLE SCHOOL RD",
            "city": "BASSETT",
            "state": "VA",
            "postal_code": "240555032",
            "telephone_number": "276-629-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "AMBER",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202011078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacinda Ann Foley, FNP
• Elizabeth W Frith, NP
• Aleta Gibbs, PHD, LPC, LSATP
• Desiree Gilbert
• Glenda's CD Service
• Bethany L Gravely
• Dane Matthew Gravely, PTA
• John Albert Hagy Sr., M.D.
• Marjorie Denise Handy, LPC
• William Harder, RPH

• Speech-Language Pathologist in Bassett, VA
• Providers in Bassett, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.