Active NPI
Robert L. Gordon Jr., M.D.
- Occupational Medicine Physician
- Jacksonville, IL
National Provider Identifier
1013013937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 036-107500
- Practice address
- 901 W Morton Ave
Suite 16a
Jacksonville, IL 62650-3145 - Phone
- (217) 479-9071
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 036-107500 | IL | Primary |
Addresses
Primary practice location
901 W Morton Ave
Suite 16a
Jacksonville, IL 62650-3145
Mailing address
1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-107500 | IL | MD | Occupational Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springfield Clinic, LLP | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1780638478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228953600000",
"number": "1013013937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 S 6TH ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627032403",
"telephone_number": "217-528-7541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 W MORTON AVE",
"address_2": "SUITE 16A",
"city": "JACKSONVILLE",
"state": "IL",
"postal_code": "626503145",
"telephone_number": "217-479-9071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "ROBERT",
"middle_name": "L.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2008-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "IL",
"license": "036-107500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.