Individual ProviderKaitlin GordonInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address401 E Chestnut St Unit 310, Louisville, KY 40202(502) 589-6788(025) 626-5105PECOS EnrollmentBased on the most recent information from CMS, provider Kaitlin Gordon is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1558723908Provider TypeIndividualFull NameGordon, KaitlinGenderFemaleSole ProprietorNoEnumeration Date3/24/2016Last Updated2/4/2020Contact InformationPractice LocationPractice Address401 E Chestnut St Unit 310, Louisville, KY 40202Phone(502) 589-6788Fax(502) 589-5093Mailing LocationMailing AddressPO Box 909, Louisville, KY 40201-0909Phone(025) 626-5105FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense52271KentuckyCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense52271Kentucky