Tracie Gordon
Individual provider Active NPI General Practice Physician · Winfield, KS
NPI 1053955153 · NPPES record last updated Oct 31, 2019
Key facts
- NPI
- 1053955153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 1164606919 (KS)
- Practice address
- 800 Main St
Winfield, KS 67156-2859 - Phone
- (620) 221-4772
- NPI assigned
- Oct 31, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1164606919 | KS | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William Newton Memorial Hospital | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 1164606919 | KS | Yes |
Addresses
Primary practice location
800 Main St
Winfield, KS 67156-2859
Mailing address
3 Black Heath CT
Winfield, KS 67156-6301
Phone (620) 222-2593
Other providers in Winfield, KS
- Joshua Frey
- Haley Geer
- Erica Christine Gibbs
- Louis Valentine Goins
- Angela M Goodson
- Kesha Elaine Grace
- Graves Drug
- Jamie A Gray
- Nicole Gray
- Grene Vision Group LLC
All providers in Winfield, KS · General Practice Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.