Wade Travis Gordon, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD469347 Issued in PA

Practice address

1 Guthrie SQ
Sayre, PA 18840-1625

Phone

(570) 887-2841

Fax

(570) 887-2364

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Practice roles

Locations

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.

• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1316936842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-887-2841",
            "fax_number": "570-887-2364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Orthopaedic Surgery - 99 MDOS/SGOSO",
            "address_2": "Mike O'Callaghan Federal Hospital",
            "address_purpose": "LOCATION",
            "city": "Nellis AFB",
            "state": "NV",
            "postal_code": "89131",
            "country_code": "US",
            "telephone_number": "702-653-3040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "WADE",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD469347",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "221155",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "221155",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wgordon147371@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Guthrie Sq",
            "city": "Sayre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "188401625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daniel Goldberg, PHD
• Daniel Golden
• Nathan Gomes, MD
• Michael Angel Gonzalez, PA
• Santina M Gordon, DPT
• Melisa Gore, CRNP
• Michael D. Gorsline, PAC
• Matthew William Gorton
• Andrew Gould, CRNA
• Rachel Marie Grant, DO

• Orthopaedic Surgery Physician in Sayre, PA
• Providers in Sayre, PA by specialty
• Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.