Gordon Troy Mork, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2205 Issued in MN

Practice address

301 Highway 65 S
Mora, MN 55051-1899

Phone

(320) 679-1212

Fax

(320) 674-9002

NPI assigned

Apr 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmork42577@excellian.direct.allina.com

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.

• Welia Health

  • Critical Access Hospital
  • Mora, MN
  • NPI 1528031390
  Medicare reassignment NPD

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1487618112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HIGHWAY 65 S",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511899",
            "telephone_number": "320-679-1212",
            "fax_number": "320-674-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HIGHWAY 65 S",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511899",
            "telephone_number": "320-679-1212",
            "fax_number": "320-674-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORK",
        "first_name": "GORDON",
        "middle_name": "TROY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "439223000",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmork42577@excellian.direct.allina.com",
            "affiliation": "Y",
            "affiliationName": "Welia Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "301 Highway 65 S",
            "city": "Mora",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550511899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Miller, SLP
• Mora Chiropractic Clinic P.C.
• Mora Dental Center
• Mora Dental Center LLC
• Mora Housing and Redevelopment Authority
• Jean Mork, PT
• Joseph Troy Mork, OD
• Kaitlyn Marie Moss
• Thomas Matthew Mullin, MD
• Whitney Naumann, APRN

• Optometrist in Mora, MN
• Providers in Mora, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.