Individual provider Active NPI

Milton Gordon

  • Pharmacist
  • Haymarket, VA
National Provider Identifier
1134719644
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20428 Issued in MD
Practice address
5581 Merchants View SQ
Haymarket, VA 20169-5439
Phone
(571) 248-4551
NPI assigned
Jan 20, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20428 MD Primary

Addresses

Primary practice location

5581 Merchants View SQ
Haymarket, VA 20169-5439

Mailing address

5581 Merchants View SQ
Haymarket, VA 20169-5439

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

State licenses

LicenseStateTypeSpecialty
20428MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Giant of Maryland LLC PastSince Jan 24, 2021 Accepting new patients
Giant of Maryland LLC PastSince Jan 24, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1134719644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5581 MERCHANTS VIEW SQ",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201695439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5581 MERCHANTS VIEW SQ",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201695439",
            "telephone_number": "571-248-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MILTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "20428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haymarket, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.