Cecil C Gordon Jr., MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

C1-0002191 Issued in DE

Practice address

611 W 18TH St
Wilmington, DE 19802-4707

Phone

(302) 658-3331

Fax

(302) 658-9306

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 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in DE

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

Specialty

Obstetrics/Gynecology

Education

University of North Carolina at Chapel Hill School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christiana Hospital Hospital, Newark, DE, CCN 080001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Christiana Care Health Services, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilmington, DE
  • NPI 1770568107
  Medicare reassignment Care Compare group NPD
• Christiana Care Health Services Inc

  • Obstetrics & Gynecology Physician
  • Newark, DE
  • NPI 1376528729
  NPD
• Christiana Care Health Services Inc

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD

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

• Christiana Care Health Services, Inc.

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184793606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W 18TH ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198024707",
            "telephone_number": "302-658-3331",
            "fax_number": "302-658-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W 18TH ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198024707",
            "telephone_number": "302-658-3331",
            "fax_number": "302-658-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CECIL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "DE",
            "license": "C1-0002191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000026401",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "62308",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "26448",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0098167000",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4198363",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Goodyear Medical Supplies
• Edris Goolsby Harrell, PH.D.
• Ainsley Norbert Gopie, RPH
• Monica Lizette Gordillo, PHD
• Camille Elaine Gordon, MD
• Janet L Gordon, MSNCPNP
• Maureen Theresa Gordon, PSY.D
• Nancy Gordon, LCSW
• Patricia Nolan Gordon, MSPT
• Jenine Lorae Mills Gordy

• Obstetrics & Gynecology Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Obstetrics & Gynecology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.