Active NPI
Gordon Gray Dorris
- Internal Medicine Physician
- Madison, AL
National Provider Identifier
1457374886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 15642
- Practice address
- 8075 Madison Blvd
Suite 101
Madison, AL 35758-2041 - Phone
- (256) 772-6220
- Fax
- (256) 461-0030
- NPI assigned
- Jul 26, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 15642 | AL | Primary |
Addresses
Primary practice location
8075 Madison Blvd
Suite 101
Madison, AL 35758-2041
Mailing address
12122 Chicamauga TRL SE
Huntsville, AL 35803-2243
Phone (256) 882-6689
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15642 | AL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choice Rehabilitation Services Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Huntsville, AL
- NPI 1952544769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457374886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12122 CHICAMAUGA TRL SE",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358032243",
"telephone_number": "256-882-6689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8075 MADISON BLVD",
"address_2": "SUITE 101",
"city": "MADISON",
"state": "AL",
"postal_code": "357582041",
"telephone_number": "256-772-6220",
"fax_number": "256-461-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORRIS",
"first_name": "GORDON",
"middle_name": "GRAY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AL",
"license": "15642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.