KANISHIA GORDON HAIR REPL SPECIALIST
NPI 1912545393
Prosthetist in Atlanta, GA

Q: What is Kanishia Gordon's NPI number?

The NPI number for Kanishia Gordon is 1912545393. It was assigned to this individual provider in the NPPES registry on December 16, 2019.

Q: What is Kanishia Gordon's specialty?

The primary specialty registered for this NPI is Prosthetist with taxonomy code 224P00000X.

Q: When was this NPI record last updated?

The NPPES record for Kanishia Gordon was last updated on December 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 December 16, 2019

519 MEMORIAL DR SE STE 209, ATLANTA, GA 30312(404) 836-3845 Get Directions Write a Review

NPPES record last updated: December 16, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Kanishia Gordon Hair Repl Specialist NPPES

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

KANISHIA GORDON HAIR REPL SPECIALIST (NPI 1912545393) is an individual prosthetist provider in Atlanta, Georgia and active in the NPI registry since December 2019.

NPPES Registry Identity

NPI1912545393

Entity TypeIndividualFemale

Primary Taxonomy224P00000X

Provider Legal NameKANISHIA GORDONCredential: HAIR REPL SPECIALIST

Location Address519 MEMORIAL DR SE STE 209Atlanta, GA 30312-2286

Mailing Address2025 Clearstream OverlookStone Mountain, GA 30088-4438 · (203) 565-5872

Phone(404) 836-3845

Sole ProprietorYes

Enumeration DateDecember 16, 2019

✔ NPI 1912545393 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetistRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code224P00000X

Definition

A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.

519 MEMORIAL DR SE STE 209, Atlanta, GA 30312

Open in Google Maps ↗

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 Kanishia Gordon's NPI number?

The NPI number for Kanishia Gordon is 1912545393. It was assigned to this individual provider in the NPPES registry on December 16, 2019.

Where is Kanishia Gordon located?

Kanishia Gordon practices at 519 Memorial Dr SE Ste 209, Atlanta, GA 30312. The listed phone number is (404) 836-3845.

What is Kanishia Gordon's specialty?

The primary specialty registered for this NPI is Prosthetist with taxonomy code 224P00000X.

When was this NPI record last updated?

The NPPES record for Kanishia Gordon was last updated on December 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.