Active NPI
Kyle McAllister Gordon, PHARMD
- Pharmacist
- Poughkeepsie, NY
National Provider Identifier
1124514484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 064084
- Practice address
- 3350 North Rd
Poughkeepsie, NY 12601-1372 - Phone
- (845) 452-6153
- NPI assigned
- Jul 10, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 064084 | NY | Primary |
Addresses
Primary practice location
3350 North Rd
Poughkeepsie, NY 12601-1372
Mailing address
22 Mango LN
Liverpool, NY 13090-3412
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064084 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eckerd Corporation | Past | Accepting new patients | |
| Eckerd Corporation | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Poughkeepsie, NY
- NPI 1164450722
-
- Community/Retail Pharmacy
- Virginia Beach, VA
- NPI 1982703120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531180800000",
"number": "1124514484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 MANGO LN",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130903412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 NORTH RD",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126011372",
"telephone_number": "845-452-6153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "KYLE",
"middle_name": "MCALLISTER",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-10",
"last_updated": "2018-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "064084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poughkeepsie, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.