Individual provider Active NPI

Douglas A. Gordon, M.D.

  • Orthopaedic Hand Surgery Physician
  • Dayton, OH
National Provider Identifier
1184688145
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
35-05-6322-G Issued in OH
Practice address
7677 Yankee St
Suite 110
Dayton, OH 45459-3475
Phone
(937) 415-9100
Fax
(937) 415-9191
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 35-05-6322-G OH Primary

Addresses

Primary practice location

7677 Yankee St
Suite 110
Dayton, OH 45459-3475

Mailing address

PO Box 713130
Cincinnati, OH 45271-0001
Phone (937) 415-9100

Other identifiers 2

IdentifierTypeStateIssuer
0725933MedicaidOH
P00356846OtherOHRAILROAD MEDICARE

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hand Surgery Associates Hand Surgery Past Accepting new patients
Orthopedic Associates of Southwestern Ohio, Inc Past Accepting new patients
Orthopedic Asoc of SW Ohio, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331856000000",
    "number": "1184688145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713130",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452710001",
            "telephone_number": "937-415-9100",
            "fax_number": "937-415-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7677 YANKEE ST",
            "address_2": "SUITE 110",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593475",
            "telephone_number": "937-415-9100",
            "fax_number": "937-415-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DOUGLAS",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2012-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "OH",
            "license": "35-05-6322-G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0725933",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00356846",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; 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.