KIMBERLY RENEE GORDON PA-C
NPI 1346562147
Physician Assistant in Waxhaw, NC

Q: What is Kimberly Gordon's NPI number?

The NPI number for Kimberly Gordon is 1346562147. It was assigned to this individual provider in the NPPES registry on February 20, 2010.

Q: What is Kimberly Gordon's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Gordon was last updated on March 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since February 20, 2010PECOS EnrolledAccepts Medicare Assignment

9929 REA RD STE 201, WAXHAW, NC 28173(704) 316-1650(704) 316-1651 Get Directions Write a Review

NPPES record last updated: March 30, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 30, 2023, Oct 26, 2020, Mar 11, 2020 and 2 more (5 updates tracked since 2016).

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About Kimberly Renee Gordon Pa-c NPPES

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

KIMBERLY RENEE GORDON PA-C (NPI 1346562147) is an individual physician assistant in Waxhaw, North Carolina, licensed in North Carolina (0010-07737) and active in the NPI registry since February 2010. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1346562147

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKIMBERLY RENEE GORDONCredential: PA-C

Location Address9929 REA RD STE 201Waxhaw, NC 28173-6439

Mailing AddressPo Box 60447Charlotte, NC 28260-0447

Phone(704) 316-1650

Fax(704) 316-1651

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateFebruary 20, 2010

Last NPPES UpdateMarch 30, 20235 updates tracked since enumeration

NPPES CertifiedMarch 30, 2023

✔ NPI 1346562147 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 0010-07737

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA9105103 (FL)

9929 REA RD STE 201, Waxhaw, NC 28173

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Secondary Practice Locations 3

Location 13131 N McMullen Booth RdClearwater, FL 33761-2008 · Phone (727) 726-8871 · Fax (727) 726-8571

Location 29623 Redstone Dr Ste 300Indian Land, SC 29707 · Phone (803) 615-0880

Location 31401 Matthews Township Pkwy Ste 320Matthews, NC 28105-5403 · Phone (704) 384-1261

Other Identifiers 2

Medicaid018579700FL

OtherY0S1DFL · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimberly Renee Gordon Pa-c 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.

PECOS PAC ID2466615612

PECOS Enrollment IDI20180718003217

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

172 services38 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

144 services49 patients

Psychiatric diagnostic evaluation with medical services 90792

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

19 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28173 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

79%560 patients1/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

93%162 patients3/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

29%312 patients2/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

63%312 patients3/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

21%312 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

17%312 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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