Krista Gordon MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21237 Issued in OK

Legal business name

KRISTA GORDON MD PC

Practice address

5366 NW Cache Rd
Suite 6
Lawton, OK 73505-3353

Phone

(580) 536-7546

Fax

(580) 581-2051

NPI assigned

May 11, 2007

Organization subpart

No

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

Authorized official

Name

Rhonda Gelvin, MD

Title

Office Manager

Phone

(580) 536-7546

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Krista Gordon, MD

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1164426193
  Medicare reassignment NPD

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1275748501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5366 NW CACHE RD",
            "address_2": "SUITE 6",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735053335",
            "telephone_number": "580-536-7546",
            "fax_number": "580-581-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5366 NW CACHE RD",
            "address_2": "SUITE 6",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735053353",
            "telephone_number": "580-536-7546",
            "fax_number": "580-581-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTA GORDON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "GELVIN",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "580-536-7546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "21237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "900522624",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey S Kopaddy
• Margaret Leslie Kopepassah, BS
• Olivia Nicole Kothmann, PHARMD
• Crystal Krey, RN
• Lauren Nicole Krieg, APRN-CNP
• Nicholas Knesek Kubelka, PH. D., D. O.
• Kuglitsch Enterprises, Inc
• Korie Alizabeth Kukurich-Rodriguez
• L&D Impact Counseling LLC
• L&D Impact Counseling, LLC

• Family Medicine Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.