NPIMap

Individual provider Active NPI

Gregory A Gordon, D.O.

  • Hematology & Oncology Physician
  • Kettering, OH
National Provider Identifier
1518917301
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
34004894 Issued in OH
Practice address
3700 Southern Blvd Ste 401
Kettering, OH 45429-1226
Phone
(855) 500-2873
Fax
(937) 281-3913
NPI assigned
May 11, 2006
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 34004894 OH Primary

Addresses

Primary practice location

3700 Southern Blvd Ste 401
Kettering, OH 45429-1226

Mailing address

3700 Southern Blvd Ste 401
Kettering, OH 45429-1226
Phone (855) 500-2873

Other identifiers 1

IdentifierTypeStateIssuer
0948925MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ggordon175054@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Greater Dayton Cancer Center Pharmacy PastSince Apr 9, 2009 Accepting new patients
Dayton Oncology & Hematology, PA Hematology & Oncology Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1518917301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 SOUTHERN BLVD STE 401",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291226",
            "telephone_number": "855-500-2873",
            "fax_number": "937-281-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 SOUTHERN BLVD STE 401",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291226",
            "telephone_number": "855-500-2873",
            "fax_number": "937-281-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GREGORY",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "34004894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0948925",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ggordon175054@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3700 Southern Blvd Ste 401",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3700 Southern Blvd Ste 401",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.