Kenric Gordon, LMSW
NPI 1114540804 · Social Worker · Chubbuck, ID
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenric Gordon, LMSW is a Social Worker provider in Chubbuck, ID (NPI 1114540804).
Provider details
- NPI number
- 1114540804
- Entity type
- Individual
- Primary specialty
- Social WorkerBehavioral Health & Social Service Providers
- Credential
- LMSW
- Sex
- Male
- Sole proprietor
- No
- License
- LMSW-39661 (ID)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-05-28
- Last updated
- 2020-05-28
- Certified
- 2020-05-28
Frequently asked questions
- What is Kenric Gordon's NPI number?
- Kenric Gordon's National Provider Identifier (NPI) is 1114540804, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kenric Gordon's specialty?
- Kenric Gordon is listed in the NPPES registry with a primary specialty of Social Worker (Behavioral Health & Social Service Providers).
- Where is Kenric Gordon located?
- Kenric Gordon's practice location on file with NPPES is 210 W Burnside Ave Ste a, Chubbuck, ID 83202-4916.
- What is Kenric Gordon's phone number?
- The practice phone number listed in the NPPES registry for Kenric Gordon is (208) 238-9000.
- Does Kenric Gordon accept Medicare?
- Kenric Gordon is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kenric Gordon's NPI active?
- Yes — Kenric Gordon's NPI (1114540804) is active in the NPPES registry as of the last update on 2020-05-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.