KELLY ELIZABETH BOUTELLE GORDON
NPI 1043154818
Student in an Organized Health Care Education/Training Program in Chapel Hill, NC

Q: What is Kelly Gordon's NPI number?

The NPI number for Kelly Gordon is 1043154818. It was assigned to this individual provider in the NPPES registry on April 14, 2026. The provider is also known as Kelly Elizabeth Boutelle.

Q: What is Kelly Gordon's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Gordon was last updated on April 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 14, 2026PECOS Enrolled

N2198, CB7010, CHAPEL HILL, NC 27599(919) 966-4873(919) 966-5136 Get Directions Write a Review

NPPES record last updated: April 14, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Kelly Elizabeth Boutelle Gordon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY ELIZABETH BOUTELLE GORDON (NPI 1043154818) is an individual student in an organized health care education/training program in Chapel Hill, North Carolina and active in the NPI registry since April 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043154818

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameKELLY ELIZABETH BOUTELLE GORDON

Location AddressN2198, CB7010Chapel Hill, NC 27599-7010

Mailing AddressN2198, Cb7010Chapel Hill, NC 27599-7010 · (919) 966-4873 · Fax (919) 966-5136

Phone(919) 966-4873

Fax(919) 966-5136

Sole ProprietorNo

Enumeration DateApril 14, 2026

NPPES CertifiedApril 14, 2026

✔ NPI 1043154818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

N2198, Chapel Hill, NC 27599

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Other Names 1

Former Name (1)Kelly Elizabeth Boutelle

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Elizabeth Boutelle Gordon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Gordon's NPI number?

The NPI number for Kelly Gordon is 1043154818. It was assigned to this individual provider in the NPPES registry on April 14, 2026. The provider is also known as Kelly Elizabeth Boutelle.

Where is Kelly Gordon located?

Kelly Gordon practices at N2198 Cb7010, Chapel Hill, NC 27599. The listed phone number is (919) 966-4873.

What is Kelly Gordon's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kelly Gordon enrolled in Medicare?

Yes. Kelly Gordon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Gordon was last updated on April 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.