NPIMap

Individual provider Active NPI

Gerald Gordon, M.D.

  • Internal Medicine Physician
  • Aiken, SC
National Provider Identifier
1396738753
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17475 Issued in SC
Practice address
102 Summerwood Way
Aiken, SC 29803-7704
Phone
(803) 649-5300
Fax
(803) 649-0056
NPI assigned
Aug 31, 2005
Last updated
Oct 22, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17475 SC Primary
Infectious Disease Physician 207RI0200X 17475 SC

Addresses

Primary practice location

102 Summerwood Way
Aiken, SC 29803-7704

Mailing address

PO Box 5238
Aiken, SC 29804-5238
Phone (803) 649-5300

Other identifiers 1

IdentifierTypeStateIssuer
174750MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000445 SC Practitioner - Infectious DiseasePractitioner - Internal Medicine 4587650791 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Columbia University College of Physicians and Surgeons, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

102 Summerwood Way
Aiken, SC 29803-7704
Phone (803) 649-5300

137 Miracle Dr
Aiken, SC 29801-6351
Phone (803) 226-0589

302 University Pkwy
Aiken, SC 29801-6302
Phone (803) 641-5000

420 Society Hill Dr
Aiken, SC 29803-1731

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Regional Medical Centers, LLC. CurrentSince Apr 20, 2015 Accepting new patients
Aiken Professional Association LLC Internal Medicine CurrentSince Apr 17, 2023 Accepting new patients
Aiken Professional Association, LLC Internal Medicine Current Accepting new patients

Locations

102 Summerwood Way
Aiken, SC 29803
Phone (803) 469-5300

137 Miracle Dr
Aiken, SC 29801
Phone (803) 226-0589

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

Interoperability endpoints

  • Direct secure messaging: geraldgordon@imaa.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1396738753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5238",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298045238",
            "telephone_number": "803-649-5300",
            "fax_number": "803-649-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SUMMERWOOD WAY",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298037704",
            "telephone_number": "803-649-5300",
            "fax_number": "803-649-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "17475",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "SC",
            "license": "17475",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174750",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.