ANDREA ALEXIS GORDON (NPI# 1306377023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306377023 |
| Entity Type | Individual |
| Full Name | ANDREA ALEXIS GORDON |
| Other Name | ANDREA ALEXIS GALLO |
| Credential | APNP |
| Practice Address |
6308 8th Avenue Ste 202 Kenosha WI 53143 |
| Mailing Address |
6308 8th Avenue, Ste 202 Kenosha WI 53143-5031 |
| Practice Telephone | 2626535330 |
| Practice Fax Number | 2626535346 |
| Mailing Telephone | 2626535330 |
| Mailing Fax Number | 2626535346 |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2018-07-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 178314-030 | WI | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 8432-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1306377023 | 05 | |
| WI | WI LICENSE | 8432-33 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9555 76th Street, Pleasant Prairie, WI 531581984 | 2626535330 | 2626535346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386192516 | Andrea Marie Gordon | Licensed Practical Nurse | 49 Ranch Village Ln, Rochester, NY 14624-2856 | 2016-09-16 |
| 1114206810 | Andrea Beth Gordon | Social Worker | 50 Penn St, Port Jefferson Station, Port Jefferson Station, NY 11776-3808 | 2011-08-11 |
| 1295861854 | Andrea Briget Gordon | Marriage & Family Therapist | 316 Redondo Ave, Long Beach, CA 90814-2651 | 2007-02-26 |
| 1437203163 | Andrea D Gordon | Social Worker | 325 Manville Rd, Pleasantville, NY 10570-2122 | 2007-01-22 |
| 1184617821 | Andrea Margareta Gordon | Physical Therapist | 5111 Abercorn St, Savannah, GA 31405-5214 | 2005-08-29 |
| 1528585973 | Andrea Elizabeth Gordon | Pharmacist | 5295 34th St S, Saint Petersburg, FL 33711-4517 | 2017-08-26 |
| 1881976868 | Andrea M Gordon | Physician Assistant | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2011-09-15 |
| 1326223116 | Andrea Jean Gordon | Counselor | 4526 Federal Ave, Everett, WA 98203 | 2007-12-31 |
| 1295725992 | Andrea Thomas Gordon | Dentist | 1408 N Kingshighway Blvd, Suite 110, Saint Louis, MO 63113-1400 | 2005-10-24 |
| 1811986292 | Andrea E Gordon | Family Medicine | 195 Canal St, Malden, MA 02148-6701 | 2005-10-18 |
| Street Address |
6308 8TH AVENUE STE 202 |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285683284 | Ihc-kenosha Radiology, LLC | Radiology | 6308 8th Avenue, Uhs Kenosha Campus, Kenosha, WI 53143-5031 | 2006-05-08 |
| 1588866644 | Chigozie Nwamaka Nweke | Internal Medicine | 6308 8th Avenue, Kenosha, WI 53143 | 2007-06-01 |
| 1982744959 | Holly Jo Dinsmore | Speech-Language Pathologist | 6308 8th Avenue, Kenosha, WI 53143 | 2007-02-07 |
| 1508813593 | Priti Dilip Patel | Internal Medicine | 6308 8th Avenue, Ste 2000, Kenosha, WI 53143 | 2006-05-27 |
| 1679520514 | Peter Mariani | Internal Medicine | 6308 8th Avenue, Suite 108, Kenosha, WI 53143 | 2006-05-27 |
| 1477500312 | Mehjabein Yaguoob Khan | Internal Medicine | 6308 8th Avenue, Suite 108, Kenosha, WI 53143 | 2006-05-27 |
| 1326094731 | Miso Niko Miloslavic | Family Medicine | 6308 8th Avenue, Suite 2000, Kenosha, WI 53143 | 2006-05-26 |
| 1144276551 | Shahid Ali Atcha | Obstetrics & Gynecology | 6308 8th Avenue, Suite 2000, Kenosha, WI 53143 | 2006-05-26 |
| 1023064508 | Alvia Moid | Internal Medicine | 6308 8th Avenue, Suite 2000, Kenosha, WI 53143 | 2006-05-26 |
| 1295781680 | Jeffrey Reid Trimark | Internal Medicine | 6308 8th Avenue, Suite 2000, Kenosha, WI 53143 | 2006-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| Find all providers in zip 53143 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710518238 | Roshonda E Frazier | Nurse Practitioner | 4517 38th Ave, Kenosha, WI 53144-3643 | 2020-02-03 |
| 1497228712 | Shannon Godbolt | Nurse Practitioner | 6308 8th Ave # 3030, Kenosha, WI 53143-5031 | 2019-01-09 |
| 1568821841 | Wisconsin Tele-med Network | Nurse Practitioner | 6923 39th Ave, Kenosha, WI 53142-7129 | 2016-02-16 |
| 1588041891 | Melissa Swierad | Nurse Practitioner | 6308 8th Ave Ste 3040, Kenosha, WI 53143-5031 | 2015-05-06 |
| 1962493635 | Mary Jamie Cairo | Nurse Practitioner | 3601 30th Ave, Ste 203, Kenosha, WI 53144-1695 | 2005-11-02 |
| 1568459568 | Gwendolyn M Perry-brye | Nurse Practitioner | 8600 Sheridan Rd Ste 600, Kenosha, WI 53143-6515 | 2005-10-04 |
| 1730796574 | Saralyn Paredes | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-7884 | 2020-09-25 |
| 1053926949 | Carly Pickos | Nurse Practitioner | 2707 15th Pl, Kenosha, WI 53140-4947 | 2020-09-09 |
| 1669094165 | Simona Slavinskiene | Nurse Practitioner | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-05-07 |
| 1134757073 | Amber Jirschele | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-8323 | 2020-03-27 |
| Find all providers in KENOSHA | ||||
Please comment or provide details below to improve the information on ANDREA ALEXIS 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.