IndividualActiveMedicare EnrolledCan Order/Refer

Kenric Glenn Gordon

LMSW

Social Worker

NPI: 1114540804Chubbuck, Idaho, 83202(208) 238-9000Male

About Kenric Glenn Gordon

Kenric Glenn Gordon, LMSW, is a male healthcare professional specializing in Social Worker, registered under National Provider Identifier (NPI) number 1114540804. Kenric Glenn Gordon received his medical education at OTHER, graduating in 2021.

Their primary practice is located at 210 W BURNSIDE AVE STE A, Chubbuck, Idaho 83202. Patients can reach the office at (208) 238-9000. Kenric Glenn Gordon is enrolled in Medicare and accepts Medicare patients, is authorized to order and refer Medicare services.

Kenric Glenn Gordon has been NPI-registered since 2020.

Key Metrics

Practice Locations

Doctor Details

Identity & Credentials

NPI Number: 1114540804
Entity Type: Individual
First Name: Kenric
Last Name: Gordon
Credential: LMSW
Gender: Male
Medical School: OTHER
Graduation Year: 2021
Sole Proprietor: No
Status: active

Primary Practice Location

Address: 210 W BURNSIDE AVE STE A
City: Chubbuck
State: Idaho
ZIP: 83202-4916
Country: United States
Phone: (208) 238-9000

Specialty & Taxonomy

Primary Specialty: Social Worker
Classification: Social Worker
Taxonomy Code: 104100000X

NPI Registration

Enumeration Date: May 28, 2020
Last Updated: May 28, 2020
Certification Date: May 28, 2020

Mailing Address

Address: 210 W BURNSIDE AVE STE A
City: CHUBBUCK
State: ID
ZIP: 832024916

Medicare Enrollment

Medicare Enrolled: Yes
Can Order/Refer: Yes
Telehealth: No
Excluded: No

Frequently Asked Questions

What is Kenric Glenn Gordon's NPI number?

Kenric Glenn Gordon's National Provider Identifier (NPI) is 1114540804. An NPI is a unique 10-digit identification number issued by the Centers for Medicare & Medicaid Services (CMS) to healthcare providers in the United States.

What does Kenric Glenn Gordon specialize in?

Kenric Glenn Gordon specializes in Social Worker. They received their medical education at OTHER (class of 2021).

Where is Kenric Glenn Gordon located?

Kenric Glenn Gordon practices at 210 W BURNSIDE AVE STE A, Chubbuck, Idaho 83202. You can reach them by phone at (208) 238-9000.

Does Kenric Glenn Gordon accept Medicare?

Yes, Kenric Glenn Gordon is enrolled in the Medicare program and accepts Medicare patients. They are also authorized to order and refer services under Medicare.

Does Kenric Glenn Gordon offer telehealth or virtual visits?

Kenric Glenn Gordon does not currently offer telehealth services. In-person visits are required at their practice location.

What is an NPI Number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to healthcare providers in the United States by the Centers for Medicare & Medicaid Services (CMS). Required under HIPAA, every healthcare provider who transmits health information electronically must have an NPI. The NPI for Kenric Glenn Gordon is 1114540804.