JOHNATHAN PAUL GORDON
NPI 1760965388
Social Worker in Pryor, OK

Q: What is Johnathan Gordon's NPI number?

The NPI number for Johnathan Gordon is 1760965388. It was assigned to this individual provider in the NPPES registry on September 10, 2018.

Q: What is Johnathan Gordon's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Johnathan Gordon was last updated on November 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 September 10, 2018PECOS Enrolled

109 N FAIRLAND ST, PRYOR, OK 74361(918) 825-1405(918) 876-3436 Get Directions Write a Review

NPPES record last updated: November 13, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 13, 2020, Sep 10, 2018 (2 updates tracked since 2018).

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About Johnathan Paul Gordon NPPES

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

JOHNATHAN PAUL GORDON (NPI 1760965388) is an individual social worker in Pryor, Oklahoma, licensed in Oklahoma (6386) and active in the NPI registry since September 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760965388

Entity TypeIndividualMale

Primary Taxonomy104100000X

Provider Legal NameJOHNATHAN PAUL GORDON

Location Address109 N FAIRLAND STPryor, OK 74361-4203

Mailing Address109 N Fairland StPryor, OK 74361-4203 · (918) 825-1405 · Fax (918) 876-3436

Phone(918) 825-1405

Fax(918) 876-3436

Sole ProprietorNo

Enumeration DateSeptember 10, 2018

Last NPPES UpdateNovember 13, 20202 updates tracked since enumeration

NPPES CertifiedNovember 13, 2020

✔ NPI 1760965388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in OK · 6386

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

109 N FAIRLAND ST, Pryor, OK 74361

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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Johnathan Paul Gordon 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.

KALI ROSE KERNS

Peer Specialist