Active NPI
Charles Marvin Gordon Jr., M.D.
- Orthopaedic Surgery of the Spine Physician
- Daphne, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery of the Spine Physician
- License
- MD36872
- Practice address
- 1505 Daphne Ave
Daphne, AL 36526 - Phone
- (251) 625-2663
- NPI assigned
- May 11, 2011
- Last updated
- Aug 1, 2018
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | MD36872 | AL | Primary |
Addresses
Primary practice location
1505 Daphne Ave
Daphne, AL 36526
Mailing address
1505 Daphne Ave
Daphne, AL 36526-4298
Phone (251) 625-2663
Other practice location 1
5 Mobile Infirmary Cir
Mobile, AL 36607-3513
Phone (251) 625-2663
Other practice location 2
750 Morphy Ave
Fairhope, AL 36532-1812
Phone (251) 625-2663
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- 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
- Orthopedic Surgery
- Education
- University of Arkansas College of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1505 Daphne Ave
Daphne, AL 36526-4298
Phone (251) 625-2663
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 201 |
| Laminectomy or laminotomy (partial removal of spine bones) | 59 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD36872 | AL | MD | Orthopaedic Surgery of the Spine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baldwin Bone & Joint P C | Orthopaedic Surgery of the Spine | Current | Accepting new patients |
| Baldwin Bone & Joint P C | Past | Accepting new patients |
Locations
2305 Hand Ave
Bay Minette, AL 36507
Phone (251) 435-1364
1505 Daphne Ave
Daphne, AL 36526
Phone (251) 625-2663
750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375
1400 N McKenzie St
Foley, AL 36535
Phone (251) 424-1200
10701 Eastern Shore Blvd
Spanish Fort, AL 36527
Phone (251) 625-2663
Interoperability endpoints
- cmg@bbj1037.srs-direct.com
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Spanish Fort, AL
- NPI 1316877764
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Thomas Hospital
- General Acute Care Hospital
- Fairhope, AL
- NPI 1447303227
-
dba USA Health Providence Hospital
- General Acute Care Hospital
- Mobile, AL
- NPI 1992489223
-
- General Acute Care Hospital
- Pensacola, FL
- NPI 1700979465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533081600000",
"number": "1275825135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 DAPHNE AVE",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365264298",
"telephone_number": "251-625-2663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 DAPHNE AVE",
"city": "DAPHNE",
"state": "AL",
"postal_code": "36526",
"telephone_number": "251-625-2663"
}
],
"practiceLocations": [
{
"address_1": "5 Mobile Infirmary Cir",
"address_purpose": "LOCATION",
"city": "Mobile",
"state": "AL",
"postal_code": "366073513",
"country_code": "US",
"telephone_number": "251-625-2663",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "750 Morphy Ave",
"address_purpose": "LOCATION",
"city": "Fairhope",
"state": "AL",
"postal_code": "365321812",
"country_code": "US",
"telephone_number": "251-625-2663",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GORDON",
"first_name": "CHARLES",
"middle_name": "MARVIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-11",
"last_updated": "2018-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "AL",
"license": "MD36872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daphne, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.