Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Louissa Carolyn Gordon, PA-C

Individual provider Physician Assistant · NPI 1821484452

Louissa Carolyn Gordon, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2014, 12 years ago. Practices with Full Circle Health Inc, a 109-clinician group and accepts Medicare assignment. Licensed in Idaho and Washington.

Years since qualifying
12
Licensed in
ID, WA
In the registry since
2015
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

121 E Fort St
Boise, ID 83712-6322
Phone: (208) 514-2525
Fax: (208) 375-2217
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-1772 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA60549072 (WA)

Record details

NPI number1821484452
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 10, 2015
Last updated in NPPESAugust 22, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Full Circle Health Inc — 109 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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