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

Jacob Gordon

Individual provider Driver · NPI 1619793015

Jacob Gordon is a Driver in Columbus, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2024
Specialties on file
3
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Practice location Address checks out

1656 Canvasback Ln
Columbus, OH 43215-7023
Phone: (419) 270-6893
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Child Intellectual and/or Developmental Disabilities Respite Care (primary) Taxonomy 385HR2060X
Driver Taxonomy 172A00000X · Licence UR685742 (OH)
Private Vehicle Taxonomy 347C00000X · Licence UR685742 (OH)

Record details

NPI number1619793015
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 2, 2024
Last updated in NPPESDecember 2, 2024
Certification dateDecember 2, 2024
Mailing address1656 Canvasback Ln, Columbus, OH 43215-7023

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