Active NPI
Charles David Gordon, M.D.
- Neurology Physician
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 2012-01542
- Practice address
- 6324 Fairview Rd Ste 400
Charlotte, NC 28210-4278 - Phone
- (980) 302-8626
- Fax
- (980) 302-8639
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 45189 | AZ | |
| Neurology Physician | 2084N0400X | 2012-01542 | NC | Primary |
Addresses
Primary practice location
6324 Fairview Rd Ste 400
Charlotte, NC 28210-4278
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-9437
Other practice location 1
1918 Randolph Rd
Suite 400
Charlotte, NC 28207-1100
Phone (704) 384-9437
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 630053 | Medicaid | AZ | |
| 5921444 | Medicaid | NC |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cgordon28955@direct.novanthealth.org | ||
| Direct Messaging Address | cgordon28955@direct.novanthealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Boston University School of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Matrix Rehabilitation South Carolina, Inc.
Practice addresses (Care Compare)
15033 Ballancroft Pkwy
Suite 200
Charlotte, NC 28277-4944
Phone (704) 316-2920
739 Galleria Blvd
Rock Hill, SC 29730-5785
Hospital & facility affiliations
- Novant Health Presbyterian Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| The Presbyterian Hospital | Internal Medicine | Current | Accepting new patients |
| Novant Medical Group Inc | Neurology | Current | Accepting new patients |
| The Presbyterian Hospital | Internal Medicine | Current | Accepting new patients |
| The Presbyterian Hospital | Internal Medicine | Current | Accepting new patients |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients | |
| Novant Health Medical Group, LLC | Internal Medicine | Past | Accepting new patients |
Locations
15033 Ballancroft Pkwy
Ste 200
Charlotte, NC 28277
Phone (704) 316-2920
6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950
6324 Fairview Rd
Ste 400
Charlotte, NC 28210
Phone (980) 302-8626
1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Organizations & group practices 8
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.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Geriatric Medicine (Internal Medicine) Physician
- Charlotte, NC
- NPI 1053365817
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Neurology Physician
- Charlotte, NC
- NPI 1215411723
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1043953813
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1740169820
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1134841802
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1396798591
Hospital
-
- Psychiatric Hospital Unit
- Charlotte, NC
- NPI 1497708838
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1881647204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623369600000",
"number": "1265525372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447",
"telephone_number": "704-384-9437",
"fax_number": "704-384-9440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6324 FAIRVIEW RD STE 400",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282104278",
"telephone_number": "980-302-8626",
"fax_number": "980-302-8639"
}
],
"practiceLocations": [
{
"address_1": "1918 Randolph Rd",
"address_2": "Suite 400",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282071100",
"country_code": "US",
"telephone_number": "704-384-9437",
"fax_number": "704-384-9440",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GORDON",
"first_name": "CHARLES",
"middle_name": "DAVID",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2021-06-11",
"certification_date": "2021-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "45189",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NC",
"license": "2012-01542",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "630053",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5921444",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cgordon28955@direct.novanthealth.org",
"affiliation": "N",
"address_1": "6324 Fairview Rd Ste 400",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282104278",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cgordon28955@direct.novanthealth.org",
"affiliation": "N",
"address_1": "1918 Randolph Rd",
"address_2": "Suite 400",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282071100",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.