Active NPI
Robert Dana Gordon, M.D.
- Transplant Surgery Physician
- Atlanta, GA
National Provider Identifier
1083939391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Transplant Surgery Physician
- License
- 036163
- Practice address
- 520 Cameron Manor Way NW
Atlanta, GA 30328-6202 - Phone
- (404) 843-2010
- Fax
- (404) 521-4646
- NPI assigned
- Mar 30, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Transplant Surgery Physician | 204F00000X | 036163 | GA | Primary |
Addresses
Primary practice location
520 Cameron Manor Way NW
Atlanta, GA 30328-6202
Mailing address
520 Cameron Manor Way NW
Atlanta, GA 30328-6202
Phone (404) 843-2010
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036163 | GA | MD | Transplant Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269907200000",
"number": "1083939391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 CAMERON MANOR WAY NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303286202",
"telephone_number": "404-843-2010",
"fax_number": "404-521-4646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 CAMERON MANOR WAY NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303286202",
"telephone_number": "404-843-2010",
"fax_number": "404-521-4646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "ROBERT",
"middle_name": "DANA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-30",
"last_updated": "2010-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "204F00000X",
"taxonomy_group": "",
"desc": "Transplant Surgery",
"state": "GA",
"license": "036163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.