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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CAROLYN JACKMAN GORDON CRNP, PMHNP-BC
NPI 1710711262
Nurse Practitioner - Psychiatric/Mental Health in Lumberton, NC

Active since August 28, 2024PECOS Enrolled
401 W 27TH ST, LUMBERTON, NC 28358(910) 370-0434 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 23, 2026, May 4, 2026, Nov 24, 2025 and 4 more (7 updates tracked since 2024).

About Carolyn Jackman Gordon Crnp, Pmhnp-bc NPPES

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

CAROLYN JACKMAN GORDON CRNP, PMHNP-BC (NPI 1710711262) is an individual psychiatric/mental health provider in Lumberton, North Carolina, licensed in North Carolina (5022591) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1710711262
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameCAROLYN JACKMAN GORDONCredential: CRNP, PMHNP-BC
Location Address401 W 27TH STLumberton, NC 28358-3019
Mailing Address34 Shining Willow Way # 239La Plata, MD 20646-4224 · (304) 542-6475 · Fax (240) 690-6614
Phone(910) 370-0434
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 28, 2024
Last NPPES UpdateJuly 23, 20267 updates tracked since enumeration
NPPES CertifiedJuly 23, 2026
✔ NPI 1710711262 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in NC · 5022591✔ Licensed in MD · AC006921
401 W 27TH ST, Lumberton, NC 28358
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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)

Carolyn Jackman Gordon Crnp, Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID547797706
PECOS Enrollment IDI20260519001067
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28358 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
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

SOUTHEASTERN HEALTH PHYSICIAN SERVICES
Internal Medicine (Pulmonary Disease)
401 W 27TH ST
LUMBERTON, NC 28358
Robeson County (910) 738-9414

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 Carolyn Jackman Gordon's NPI number?

The NPI number for Carolyn Jackman Gordon is 1710711262. It was assigned to this individual provider in the NPPES registry on August 28, 2024.

Where is Carolyn Jackman Gordon located?

Carolyn Jackman Gordon practices at 401 W 27th St, Lumberton, NC 28358. The listed phone number is (910) 370-0434.

What is Carolyn Jackman Gordon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Carolyn Jackman Gordon enrolled in Medicare?

Yes. Carolyn Jackman Gordon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carolyn Jackman Gordon was last updated on July 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days 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.