Katrina Gordon, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R2346 Issued in TX

Practice address

109 N Aberdeen St
Chicago, IL 60607-1668

Phone

(312) 219-2230

NPI assigned

Jun 3, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgordon294551@direct.sw.org

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.

• One Medical Group, Inc.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1588382832
  Medicare reassignment NPD
• One Medical Group, Inc

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1891521134
  NPD

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1306072467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N ABERDEEN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071668",
            "telephone_number": "312-219-2230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4036 CROMWELL DR",
            "address_purpose": "LOCATION",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "78640",
            "country_code": "US",
            "telephone_number": "512-654-4600",
            "fax_number": "512-654-4601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KATRINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R2346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgordon294551@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4036 CROMWELL DR",
            "city": "KYLE",
            "state": "TX",
            "country_code": "US",
            "postal_code": "78640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jill Gordon, MSW, LCSW
• Jonathan Gordon, MD
• Julia Gordon, APRN-BC
• Justin R Gordon, OD
• Katherine Gordon, CRNA
• Keya M Gordon, DC
• Laurence R Gordon, DO
• Leo Gordon, MD
• Leslie Gordon
• Lindsay Gordon

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.