Kenneth Lawrence Gordon, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

135128 Issued in NY

Practice address

75 Chestnut St.
Oneonta, NY 13820

Phone

(607) 433-1663

NPI assigned

Feb 9, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 27, 2012 through Nov 27, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• At Home Care Incorporated

  • Home Health Agency
  • Oneonta, NY
  • NPI 1003819806
  NPD (past)
• At Home Care Partners, Inc.

  • Home Health Agency
  • Oneonta, NY
  • NPI 1033754494
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1548301021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CHESTNUT ST.",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "13820",
            "telephone_number": "607-433-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 CHESTNUT ST.",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "13820",
            "telephone_number": "607-433-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KENNETH",
        "middle_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "135128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Gibbs, RN, BC FNP
• Linda A Gilmore, RNBC
• Joseph David Glowienka
• Siarra Izabella Goodhue, PA-C
• Corey Regina Goodrich, RPH
• Christina Lynn Graham, LPN
• Norie Grant
• William Eugene Grappone, MSW
• Jennifer Green, COTA
• Jennifer L Grigoli, PMHNP, DNS

• Child & Adolescent Psychiatry Physician in Oneonta, NY
• Providers in Oneonta, NY by specialty
• Child & Adolescent Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.