Kathleen G Gordon, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

200301119 Issued in NC

Practice address

Unc CH Department of Ophthalmology
130Mason Farm Rd, 5151 Bioinformatics
Chapel Hill, NC 27599-7040

Phone

(919) 966-5296

Fax

(919) 966-1908

NPI assigned

Aug 3, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Duke Health Integrated Practice, Inc.

  • General Practice Physician
  • Durham, NC
  • NPI 1205553369
  NPD (past)
• North Carolina Eye Ear Nose & Throat PA

  • Ophthalmology Physician
  • Durham, NC
  • NPI 1972504926
  NPD (past)

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1093716896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BENDING BRANCH CT",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605904",
            "telephone_number": "919-678-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNC CH DEPARTMENT OF OPHTHALMOLOGY",
            "address_2": "130MASON FARM RD, 5151 BIOINFORMATICS",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997040",
            "telephone_number": "919-966-5296",
            "fax_number": "919-966-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KATHLEEN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200301119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5177534",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "805415",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICARE",
            "identifier": "31770",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "1366A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2129642",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D5541",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0800622",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891366A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharine Mae King Gor, MD
• Jennifer Lynn Goralski, MD
• Kathryn Gordon-Escobar, PA-C
• Brett Adam Gordon, PA-C
• Diana W Gordon, RN, CPNP
• Kelly Elizabeth Boutelle Gordon
• Meghan Pavelka Gordon
• Martin Michael Goree, MD
• Macy Williamson Gorga, M.S., LMFT
• Jay Goss

• Ophthalmology Physician in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.