KENDRA MARIE GORDON
NPI 1104712801
Nurse Practitioner - Primary Care in Charleston, SC
About Kendra Marie Gordon NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENDRA MARIE GORDON (NPI 1104712801) is an individual primary care provider in Charleston, South Carolina, licensed in South Carolina (30532) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
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 and accepts Medicare assignment
Kendra Marie Gordon is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kendra Gordon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Charleston, SC 29425
- Reassigned Medicare billing, South Carolina enrollment
- 2,594 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 29425 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.
CHARLESTON, SC 29425
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 Kendra Gordon's NPI number?
The NPI number for Kendra Gordon is 1104712801. It was assigned to this individual provider in the NPPES registry on June 17, 2025.
Where is Kendra Gordon located?
Kendra Gordon practices at 171 Ashley Ave, Charleston, SC 29425. The listed phone number is (843) 792-1414.
What is Kendra Gordon's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Kendra Gordon enrolled in Medicare?
Yes. Kendra Gordon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kendra Gordon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kendra Gordon reassigns Medicare benefits to University Medical Associates Of The Medical University Of South Carol (Charleston, SC). 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 Kendra Gordon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kendra Gordon accept?
Health plans from First Choice Next and UnitedHealthcare list Kendra 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 Kendra Gordon was last updated on July 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Kendra Marie Gordon · NPI 1104712801
Primary Care physician in Charleston, South Carolina. Individual provider, active in the CMS NPPES registry since June 17, 2025.
## Identity
- **NPI:** 1104712801 (Entity type: Individual)
- **Enumerated:** June 17, 2025
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** 30532 (South Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 171 ASHLEY AVE, Charleston, SC 29425-8900
- **Phone:** (843) 792-1414
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Medical Associates Of The Medical University Of South Carol (NPI 1013934629, Charleston, SC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** July 12, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104712801) · Data from the CMS NPPES public registry.