PHEBE GORDON NPC
NPI 1093264996
Nurse Practitioner - Pediatrics in Detroit Lakes, MN
About Phebe Gordon Npc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PHEBE GORDON NPC (NPI 1093264996) is an individual pediatrics provider in Detroit Lakes, Minnesota, licensed in Minnesota (CNP 4837) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Phebe Gordon Npc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Phebe Gordon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Detroit Lakes, MN 56501
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: St Marys Regional Health Center
- 254 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 56501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Phebe Gordon's NPI number?
The NPI number for Phebe Gordon is 1093264996. It was assigned to this individual provider in the NPPES registry on October 3, 2016.
Where is Phebe Gordon located?
Phebe Gordon practices at 1027 Washington Ave, Detroit Lakes, MN 56501. The listed phone number is (218) 847-5611.
What is Phebe Gordon's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Phebe Gordon enrolled in Medicare?
Yes. Phebe Gordon is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Phebe Gordon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Phebe Gordon reassigns Medicare benefits to St Mary's Regional Health Center (Detroit Lakes, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Phebe Gordon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Phebe Gordon accept?
Health plans from Sanford Health Plan list Phebe Gordon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Phebe Gordon was last updated on December 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.
# Phebe Gordon, NPC · NPI 1093264996
Pediatrics physician in Detroit Lakes, Minnesota. Individual provider, active in the CMS NPPES registry since October 3, 2016.
## Identity
- **NPI:** 1093264996 (Entity type: Individual)
- **Enumerated:** October 3, 2016
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** CNP 4837 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 1027 WASHINGTON AVE, Detroit Lakes, MN 56501-3409
- **Phone:** (218) 847-5611
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** St Mary's Regional Health Center (NPI 1134118250, Detroit Lakes, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 21, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1093264996) · Data from the CMS NPPES public registry.