Todd Russell Gordon, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD 21158 Issued in OR

Practice address

1892 Williams St
VA Medical Center
Fort Harrison, MT 59636

Phone

(406) 447-7476

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043301096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 PINE ST",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596016360",
            "telephone_number": "406-457-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1892 WILLIAMS ST",
            "address_2": "VA MEDICAL CENTER",
            "city": "FORT HARRISON",
            "state": "MT",
            "postal_code": "59636",
            "telephone_number": "406-447-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "TODD",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD 21158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael R Gantz, PHARMD, RPH
• Jessica Dawn Garner, PSY.D.
• Cindy Joy Garza, APRN
• Meghan Gibson, RD
• Ann L. Gidel, R PH
• Sarah M Grebenc
• Aaron Grusonik
• Steven John Guerrero, RN
• Maurice Paul Hamill, DPM
• Bradley Raymond Heil, RPH

• Internal Medicine Physician in Fort Harrison, MT
• Providers in Fort Harrison, MT by specialty
• Internal Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.