KEISHA-ANN GORDON-PRIMUS (FNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1093196537
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for KEISHA-ANN GORDON-PRIMUS (FNP-BC)
7901 4TH ST N STE 300
ST PETERSBURG, FL 337024399
Phone: (407) 863-4048
Fax: (407) 987-6560
Type: Mailing
10701 INTERNATIONAL DR
ORLANDO, FL 328217392
Phone: (866) 389-2727
Fax: (401) 216-3854
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $1,819.
Total Amount is formed as General ($1,819) + Research ($0) + Ownership ($0) = $1,819.
Last reported payment date: 2024-08-15 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($245).
Total Amount
$1,819
General + Research + Ownership
Payments
16
Total payment records
General Amount
$1,819
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-15
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-10-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170221001332 | I | Nurse Practitioner | FL | TBD |
| I20230518001192 | I | Nurse Practitioner | NY | TBD |
| I20240923002991 | I | Nurse Practitioner | TX | TBD |
| I20250917004763 | I | Nurse Practitioner | DC | TBD |
| I20251031000464 | I | Nurse Practitioner | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33702)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | FL | |
| Clinical Social Worker | FL | |
| Clinical Social Worker | FL | |
| Mental Health Counselor | FL | |
| Mental Health Counselor | CA | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Clinical Social Worker | FL | |
| Clinical Social Worker | FL |
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