Individual provider Active NPI

Sherry Alexis Gordon, MD

  • Urology Physician
  • North Richland Hills, TX
National Provider Identifier
1548256464
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
M1715 Issued in TX
Practice address
4300 City Point Dr
Suite 201
North Richland Hills, TX 76180-8380
Phone
(817) 784-8268
Fax
(817) 590-2285
NPI assigned
Sep 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X M1715 TX Primary

Addresses

Primary practice location

4300 City Point Dr
Suite 201
North Richland Hills, TX 76180-8380

Mailing address

4300 City Point Dr
Suite 201
North Richland Hills, TX 76180-8380
Phone (817) 784-8268

Other identifiers 5

IdentifierTypeStateIssuer
173501101MedicaidTX
173501102MedicaidTX
173501105MedicaidTX
173501103MedicaidTX
173501104OtherTXMEDICAID OTHER

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 Medicine

State licenses

LicenseStateTypeSpecialty
M1715TXMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Associates of North Texas LLP Urology 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.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1548256464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 CITY POINT DR",
            "address_2": "SUITE 201",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761808380",
            "telephone_number": "817-784-8268",
            "fax_number": "817-590-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 CITY POINT DR",
            "address_2": "SUITE 201",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761808380",
            "telephone_number": "817-784-8268",
            "fax_number": "817-590-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SHERRY",
        "middle_name": "ALEXIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "M1715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173501101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173501102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173501105",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173501103",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OTHER",
            "identifier": "173501104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Richland Hills, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.