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DR. JARED JUNIOR JACOB GORDON MD
NPI 1407606536
Student in an Organized Health Care Education/Training Program in Roanoke, VA

Active since March 22, 2024PECOS Enrolled
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014(540) 981-7000 Get Directions Write a Review

NPPES record last updated: March 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jared Junior Jacob Gordon Md NPPES

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

DR. JARED JUNIOR JACOB GORDON MD (NPI 1407606536) is an individual student in an organized health care education/training program in Roanoke, Virginia and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407606536
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JARED JUNIOR JACOB GORDONCredential: MD
Location Address1906 BELLEVIEW AVE SERoanoke, VA 24014-1838
Mailing Address1906 Belleview Ave SeRoanoke, VA 24014-1838 · (540) 529-9230
Phone(540) 981-7000
Sole ProprietorYes
Enumeration DateMarch 22, 2024
Last NPPES UpdateMarch 26, 2024
NPPES CertifiedMarch 26, 2024
✔ NPI 1407606536 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.
1906 BELLEVIEW AVE SE, Roanoke, VA 24014
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jared Junior Jacob Gordon Md 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.

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.

JOHN K THOMPSON PA-C, ATC
Physician Assistant
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
DR. JAMES LIGHT MD
Anesthesiology
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
SUJINA PRADHAN M.D.
Family Medicine
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
DR. SAMMY ZAKI ELSARRAG M.D.
Anesthesiology
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
NIMA JAHROMI DO
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
NICOLE SCHULTZ
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
TAYLOR ALEXIS KEYS
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
NATHAN WILLIAM WAKEFIELD
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000

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 Jared Gordon's NPI number?

The NPI number for Jared Gordon is 1407606536. It was assigned to this individual provider in the NPPES registry on March 22, 2024.

Where is Jared Gordon located?

Jared Gordon practices at 1906 Belleview Ave SE, Roanoke, VA 24014. The listed phone number is (540) 981-7000.

What is Jared 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 Jared Gordon enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jared Gordon was last updated on March 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.