Shyla Gordon, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

12200 Park Central Dr Ste 400
Dallas, TX 75251-2116

Phone

(930) 021-4483

NPI assigned

Aug 25, 2021

Last updated

Mar 8, 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

Enrolled in TX, WA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Magella Medical Associates Billing, Inc.

  dba Magella Medical Associates

  • Neonatal-Perinatal Medicine Physician
  • Round Rock, TX
  • NPI 1083631071
  Medicare reassignment
• Seattle Children's Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment
• Seattle Childrens Hospital

  dba Seattle Childrens Outpatient Pharmacy

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• Seattle Children's Hospital

  • Home Infusion Agency
  • Bothell, WA
  • NPI 1245383348
  NPD (past)

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1972270114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7545 E NORTWEST HWY",
            "address_2": "APT 341",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752387484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DR STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512116",
            "telephone_number": "930-021-4483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5415 Maple Ave Apt 110",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357484",
            "country_code": "US",
            "telephone_number": "337-485-1975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SHYLA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Gordon, MD
• Lara Hess Gordon, OTR/L
• Murray Gordon, MD
• Patricia Odom Gordon, FNP-BC
• Robert Gordon, J.D., PH.D.
• Tremisha Gordon
• Tricia Ann Gordon
• Amber Gore, RN
• Autumn Gore, DC
• Bobbie Gore, PHARMD

• Surgical Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.