Active NPI
Doris S Gordon, PH.D.
- Clinical Psychologist
- Atlanta, GA
National Provider Identifier
1972721173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 801
- Practice address
- 1708 Peachtree St NW
Suite 400
Atlanta, GA 30309-2434 - Phone
- (404) 873-4414
- Fax
- (404) 874-8305
- NPI assigned
- Apr 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 801 | GA | Primary |
| Clinical Psychologist | 103TC0700X | 4661 | NC |
Addresses
Primary practice location
1708 Peachtree St NW
Suite 400
Atlanta, GA 30309-2434
Mailing address
1708 Peachtree St NW
Suite 400
Atlanta, GA 30309-2434
Phone (404) 873-4414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150624000495 | NC | Practitioner - Clinical Psychologist | 8325359938 | Practice locations: Asheville, NC |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
53 Arlington St
Asheville, NC 28801-2005
Phone (404) 310-7422
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4661 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430697600000",
"number": "1972721173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1708 PEACHTREE ST NW",
"address_2": "SUITE 400",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303092434",
"telephone_number": "404-873-4414",
"fax_number": "404-874-8305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1708 PEACHTREE ST NW",
"address_2": "SUITE 400",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303092434",
"telephone_number": "404-873-4414",
"fax_number": "404-874-8305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "DORIS",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2015-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "801",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "4661",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.