Phillip V Gordon, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101227934 Issued in VA

Practice address

5149 N 9TH Ave
Pensacola, FL 32504-8756

Phone

(434) 996-4974

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Gulf Health Hospitals, Inc

  • General Acute Care Hospital
  • Fairhope, AL
  • NPI 1447303227
  NPD (past)
• Mobile Infirmary Association

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1558364802
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1164591798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SEASHORE DR",
            "city": "PENSACOLA BEACH",
            "state": "FL",
            "postal_code": "325612427",
            "telephone_number": "434-996-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5149 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048756",
            "telephone_number": "434-996-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "PHILLIP",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101227934",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "LA",
            "license": "MD.201795",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "FL",
            "license": "115952",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006714455",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036340",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05921278",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gordon T Couch MD
• Donald Wayne Gordon, RPH
• Elise Treff Gordon, MD
• Kaleigh Gordon, APRN
• Morgan Brittney Gordon, PA-C
• Ethan McCaleb Gore, M.D.
• Kathryn Ann Gormandy, PA-C
• Erozi R Gormanson
• Debora Kay Gormley
• Robert P Gormley, M.D.

• Pediatrics Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.