Paul H Gordon, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20471 Issued in IA

Practice address

1010 4TH St SW
Mason City, IA 50401-2857

Phone

(641) 422-6020

Fax

(641) 422-7803

NPI assigned

Aug 22, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• North Iowa Mercy Clinics

  • Family Medicine Physician
  • Mason City, IA
  • NPI 1922118918
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215043013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S ILLINOIS AVE",
            "address_2": "SUITE 103",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504015489",
            "telephone_number": "641-494-3041",
            "fax_number": "641-494-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 4TH ST SW",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012857",
            "telephone_number": "641-422-6020",
            "fax_number": "641-422-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "PAUL",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "20471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150425",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "12236",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Good Shepherd Geriatric Center, Inc.
• Good Shepherd Geriatric Center, Inc.
• Good Shepherd Geriatric Center, Inc.
• Good Shepherd Geriatric Center, Inc.
• Susan Ann Goranson
• Bridget Powers Grady, LMFT
• Traci Grady, R.N.
• Sarah Grant, BA
• Tonya L Gray, MD
• Sharon Jeanette Griffiths, PHARMD

• All providers in Mason City, IA
• Emergency Medicine Physician in Iowa

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.