Renee Gordon LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002136 Issued in GA

Legal business name

RENEE GORDON LLC

Practice address

2405 Ashford Dr
Albany, GA 31721-9246

Phone

(229) 344-6117

NPI assigned

Jun 5, 2014

Organization subpart

No

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

Authorized official

Name

Renee Candace Ahlmark-Gordon, OD

Title

Owner

Phone

(229) 344-6117

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1053724203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 ASHFORD DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317219246",
            "telephone_number": "229-344-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 ASHFORD DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317219246",
            "telephone_number": "229-344-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEE GORDON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "AHLMARK-GORDON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "CANDACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-344-6117",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Albany, GA
• Providers in Albany, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.