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

Kevin Ray Gordon, NP

Individual provider Acute Care Nurse Practitioner · NPI 1124791678

Kevin Ray Gordon, NP is a Nurse Practitioner in Indianapolis, Indiana. Qualified in 2021, 5 years ago. Practices with Community Physician Network Specialty Care LLC, a 252-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
5
Licensed in
IN
In the registry since
2021
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

8075 N Shadeland Ave Ste 330
Indianapolis, IN 46250-2694
Phone: (317) 355-7220
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 550 University Blvd, Indianapolis, IN 46202-5149 — (317) 944-5000
  • 1701 N Senate Ave, Indianapolis, IN 46202-5306 — (317) 962-2000

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 71011370A (IN)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 71011370A (IN)

Record details

NPI number1124791678
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJuly 30, 2021
Last updated in NPPESAugust 12, 2025
Certification dateAugust 12, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Community Physician Network Specialty Care Llc — 252 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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