Individual provider Active NPI

Robert L Gordon, M.D.

  • Emergency Medicine Physician
  • Middletown, RI
National Provider Identifier
1265584379
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD04002 Issued in RI
Practice address
67 Valley Rd
Middletown, RI 02842-7274
Phone
(401) 847-4950
Fax
(401) 847-5767
NPI assigned
Jan 17, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 37388 MA
Emergency Medicine Physician 207P00000X MD04002 RI Primary

Addresses

Primary practice location

67 Valley Rd
Middletown, RI 02842-7274

Mailing address

58 Gaspee Point Dr
Warwick, RI 02888-4918
Phone (401) 781-1006

Other practice location 1

1589 Fall River Ave
Seekonk, MA 02771-3710
Phone (508) 336-4550

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

State licenses

LicenseStateTypeSpecialty
37388MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Warwick Medical Walk in Emergency Medicine Past Accepting new patients
Newport County Medical Treatment Office Emergency Medicine PastSince Feb 12, 2018 Accepting new patients
Route 6 Walk in Emergency Office Emergency Medicine 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1265584379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 GASPEE POINT DR",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028884918",
            "telephone_number": "401-781-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 VALLEY RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028427274",
            "telephone_number": "401-847-4950",
            "fax_number": "401-847-5767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1589 Fall River Ave",
            "address_purpose": "LOCATION",
            "city": "Seekonk",
            "state": "MA",
            "postal_code": "027713710",
            "country_code": "US",
            "telephone_number": "508-336-4550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "37388",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "MD04002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.