DR. KALI L GORDON (M.D., M.S.) – Family Medicine Physician, NPI 1508106600

DR. KALI L GORDON (M.D., M.S.) is a healthcare provider. based in Acworth, Georgia. specializing in Family Medicine Physician. They hold the professional credentials M.D., M.S.. They hold a License No. 72733 (GA). The NPI Number for DR. KALI L GORDON (M.D., M.S.) is 1508106600

Main info

Female
Sole Proprietor
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. KALI L GORDON (M.D., M.S.)
NPI
1508106600
Phone
(404) 989-7384
Address
6380 BELLS FERRY RD STE 107
Enumeration Date
26 February 2013
Last Update Date
9 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6782733456
Graduation Year
2002 (24 years ago)
PAC ID
7012265275
Group Practice PAC ID
7911213244
Professional Enrollment ID
I20180803000622
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:13State licenses:1Digital endpointsOther names

Provider Addresses for DR. KALI L GORDON (M.D., M.S.)

  • 6380 BELLS FERRY RD STE 107

    ACWORTH, GA 301025435

    Phone: (404) 989-7384

    Type: Location

  • 412 E NORTH ST UNIT A

    ALTURAS, CA 961014072

    Phone: (215) 260-8867

    Type: Mailing

  • PIT RIVER HEALTH SERVICE

    150 BUREAU OF INDIAN AFFAIRS #76A

    ALTURAS, CA 96101

    Phone: (530) 233-3223

    Fax: (530) 233-3296

    Type: Location

  • 11 UPPER RIVERDALE RD SW

    RIVERDALE, GA 302742615

    Phone: (770) 897-7033

    Fax: (770) 996-3941

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2018-08-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180803000622IGeneral PracticeGATBD

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.

Verify on CMS Revalidation Lookup Tool

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 30102)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911213244View full group profile

Reviews

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Frequently asked questions

Does DR. KALI L GORDON (M.D., M.S.) have a public NPI I can cite?
Public records show DR. KALI L GORDON (M.D., M.S.) under NPI 1508106600.
Does the public listing show DR. KALI L GORDON (M.D., M.S.) as active?
DR. KALI L GORDON (M.D., M.S.)'s NPI record reflects an active status in NPPES.
Which specialty label fits DR. KALI L GORDON (M.D., M.S.)?
NPPES ties DR. KALI L GORDON (M.D., M.S.) to Family Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is DR. KALI L GORDON (M.D., M.S.) tied to Acworth, Georgia?
If you are local to Acworth, Georgia, DR. KALI L GORDON (M.D., M.S.) may be relevant to your search.
Can I export DR. KALI L GORDON (M.D., M.S.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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