CHANEL GORDON (NPI# 1184267346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184267346 |
| Entity Type | Individual |
| Full Name | CHANEL GORDON |
| Practice Address |
1731 W Baseline Rd Ste 107 Mesa AZ 85202-5730 |
| Practice Telephone | 4806872336 |
| Mailing Telephone | 5138285597 |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2019-10-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760877666 | Chanel Gordon | Physician Assistant | 8500 Wilshire Blvd, Beverly Hills, CA 90211-3121 | 2015-03-30 |
| Street Address |
1731 W BASELINE RD STE 107 |
| City | MESA |
| State | AZ |
| Zip Code | 85202-5730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275173536 | Samuel A Wolde | Counselor | Clear View Counseling, 2651 W Guadalupe Rd, Mesa, AZ 85202 | 2020-01-14 |
| 1912549171 | Lauren Barbara Loges | Occupational Therapist | 2225 E. Southern Avenue, Mesa, AZ 85202 | 2019-10-09 |
| 1245724822 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1450 S Dobson Rd Ste B326, Mesa, AZ 85202 | 2018-06-18 |
| 1457843310 | Jay Douglas Baumgardner | Physical Therapist | 1941 W. Guadalupe Rd. Suite 109, Mesa, AZ 85202 | 2018-06-05 |
| 1144746215 | Alyson Fix | Physician Assistant | 1432 S Dobson Rd Ste 304, Mesa, AZ 85202 | 2017-08-20 |
| 1194108852 | Robert Dale Labrum | Counselor | 1255 W Baseline Rd Ste B-258, Mesa, AZ 85202 | 2015-06-30 |
| 1114325677 | John David Shull Jr. | Physician Assistant | 1520 S Dobson Rd Ste 305, Mesa, AZ 85202 | 2014-12-16 |
| 1316356207 | Embry Womens Health LLC | Nurse Practitioner | 2204 S Dobson Road, Suite 203, Mesa, AZ 85202 | 2014-08-05 |
| 1619312899 | Fiza Naueed Khan | Internal Medicine | 1400 South Dobson Road, Attn: Bmg Hospitalists Team/amanda Gump, Mesa, AZ 85202 | 2013-05-01 |
| 1487903373 | Jodi Lynn Mealer | Pharmacist | 1951 W. Baseline Rd., Mesa, AZ 85202 | 2012-09-06 |
| Find all providers in zip 85202 | ||||
| Taxonomy Code | 1744P3200X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| Specialization | Prosthetics Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295789196 | Gerald L Echols | Specialist | 1241 E. Broadway #28, Mesa, AZ 85204-2254 | 2006-05-22 |
| 1669907150 | Tommie Foxworth | Specialist | 1616 E Main St, Suite 102-103, Mesa, AZ 85203-9071 | 2017-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144772054 | Joe Bezerra | Specialist | 39818 N Bell Meadow Trl, Phoenix, AZ 85086 | 2016-10-26 |
| 1942626486 | Sishana Janelle Gerald | Specialist | 4045 E Broadway Blvd, Tucson, AZ 85711-3454 | 2014-03-07 |
| 1023375516 | Edna Mae Harris | Specialist | 6970 E 22nd St, Suite #110, Tucson, AZ 85710-5121 | 2012-04-20 |
| 1356718480 | Margo Grant-bryan | Specialist | 19395 N John Wayne Pkwy, Maricopa, AZ 85139-2833 | 2015-08-24 |
| 1154338440 | Shannon Cole Winn | Specialist | 1075 S Idaho Rd, Suite 101, Apache Junction, AZ 85219-6496 | 2006-08-01 |
Please comment or provide details below to improve the information on CHANEL GORDON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.