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

Landis Coffee Gordon, PA-C

Individual provider Physician Assistant · NPI 1457329641

Landis Coffee Gordon, PA-C is a Physician Assistant in Tifton, Georgia. Qualified in 2002, 24 years ago. Practices with Tift Regional Health System Inc, a 292-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
24
Licensed in
GA
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2227 US Highway 41 N
Tifton, GA 31794-2749
Phone: (229) 386-5222
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 901 18th St E, Tifton, GA 31794-3648 — (229) 382-7120
  • 3527 N Valdosta Road, Valdosta, GA 31602 — (229) 247-2290

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 003887 (GA)

Record details

NPI number1457329641
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 14, 2006
Last updated in NPPESOctober 10, 2023
Certification dateOctober 10, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Tift Regional Health System Inc — 292 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Tifton