NPIMap

Individual provider Active NPI

Carolyn V Gordon, MD

  • Internal Medicine Physician
  • Morganton, NC
National Provider Identifier
1154358786
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2014-02183 Issued in NC
Practice address
117 Foothills Dr
Morganton, NC 28655-5152
Phone
(828) 580-2700
Fax
(828) 432-9833
NPI assigned
Jun 27, 2006
Last updated
Sep 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2014-02183 NC Primary

Addresses

Primary practice location

117 Foothills Dr
Morganton, NC 28655-5152

Mailing address

117 Foothills Dr
Morganton, NC 28655-5152
Phone (828) 580-2700

Other identifiers 1

IdentifierTypeStateIssuer
1154358786MedicaidNC

Other names 1

  • Carolyn M Vance Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150528000153 NC Practitioner - Internal Medicine 6103886585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Emory University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

117 Foothills Dr
Morganton, NC 28655-5152
Phone (828) 580-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group, Inc. Internal Medicine CurrentSince May 1, 2015 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince May 1, 2015 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Past Accepting new patients

Locations

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

117 Foothills Dr
Morganton, NC 28655
Phone (828) 437-0847

Interoperability endpoints

  • Direct secure messaging: cgordon845832@direct.unc.nchie.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1154358786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 FOOTHILLS DR",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286555152",
            "telephone_number": "828-580-2700",
            "fax_number": "828-432-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 FOOTHILLS DR",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286555152",
            "telephone_number": "828-580-2700",
            "fax_number": "828-432-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CAROLYN",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2014-02183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154358786",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "VANCE",
            "middle_name": "M",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morganton, NC

Sources for this page

Verify at the official NPI Registry.