Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kenyetta Michelle Gordon, MD

Individual provider Family Medicine Physician · NPI 1013101161

Dr. Kenyetta Michelle Gordon, MD is a Family Practice in Crescent City, California. Qualified in 2006, 20 years ago. Practices with United Indian Health Services, Inc, a 27-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arkansas, California and Nevada.

Years since qualifying
20
Licensed in
AR, CA, NV
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1675 Northcrest Dr
Crescent City, CA 95531-8928
Phone: (707) 464-2750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 501 N Indian Rd, Smith River, CA 95567-9509 — (707) 487-0215

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence C186176 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 19863 (NV)
Family Medicine Physician Taxonomy 207Q00000X · Licence E-6423 (AR)

Record details

NPI number1013101161
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 31, 2007
Last updated in NPPESMay 26, 2023
Certification dateMay 26, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice United Indian Health Services, Inc. — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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