Karyn Bayyinah Gordon, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

98-00875 Issued in NC

Practice address

2295 E 14TH St
Ste 100
Winston Salem, NC 27105-6804

Phone

(336) 716-2255

Fax

(336) 725-2173

NPI assigned

Aug 23, 2005

Last updated

Apr 21, 2011By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1144213414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255",
            "fax_number": "336-725-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 E 14TH ST",
            "address_2": "STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271056804",
            "telephone_number": "336-716-2255",
            "fax_number": "336-725-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KARYN",
        "middle_name": "BAYYINAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "98-00875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7910406",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cierra Holly Gordon, MS, SLP
• Cortney Gordon
• Frances Friedensen Gordon, M.ED., LPC, LCAS
• Jonah Phillip Gordon
• Kaitlyn Gordon, MD
• Kimberly Anne Gordon, CRNA
• Latonya Cowser Gordon, DDS
• Regina Ann Gordon, RD, LDN
• Sarah Nicole Gordon, PA-C
• Gillian Gore

• Pediatrics Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.