Frederick Kennedy Gordon, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

25MA05220600 Issued in NJ

Practice address

2500 Morris Ave
Suite 200
Union, NJ 07083-5600

Phone

(908) 688-8630

Fax

(908) 688-0869

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548354897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MORRIS AVE",
            "address_2": "SUITE 200",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835600",
            "telephone_number": "908-688-8630",
            "fax_number": "908-688-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MORRIS AVE",
            "address_2": "SUITE 200",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835600",
            "telephone_number": "908-688-8630",
            "fax_number": "908-688-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "FREDERICK",
        "middle_name": "KENNEDY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MA05220600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Gonzalez
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• Kastoril Gopinathan, M.D.
• Kristen Goracy
• Jason Gordon, DDS, MD
• Jonathan Benneke Gorman
• Blondene Patrice Goulbourne, LAC
• Grace Excellency Care
• Gracie Home Health Care, Inc

• Sports Medicine (Orthopaedic Surgery) Physician in Union, NJ
• Providers in Union, NJ by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New Jersey

• 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.

Verify at the official NPI Registry.