NPIMap

Individual provider Active NPI

Katherine E. Gordon, M.D

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1558370346
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20286 Issued in SC
Practice address
76 Polo Rd
Columbia, SC 29223-2806
Phone
(803) 699-7255
NPI assigned
Aug 8, 2006
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2000-00804 NC
Family Medicine Physician 207Q00000X 20286 SC Primary

Addresses

Primary practice location

76 Polo Rd
Columbia, SC 29223-2806

Mailing address

1910 Gregg Street
Columbia, SC 29201-2618
Phone (803) 779-1420

Other practice location 1

205 Medical Cir
West Columbia, SC 29169-3653
Phone (803) 814-2288

Other identifiers 5

IdentifierTypeStateIssuer
99563OtherMEDCOST
12645OtherNCBCBS
20286OtherSCSC LICENSE
P00399279OtherMEDICARE RAILROAD
8912645MedicaidNC

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kgordon11703@direct.lexmed.com
Direct Messaging Address kgordon11703@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120119000046 SC Practitioner - Family Practice 7416144035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

109 Barton Creek CT
Columbia, SC 29229-8027
Phone (803) 791-2683

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2000-00804NCMDFamily Medicine Physician
20286SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc Family Medicine CurrentSince Aug 21, 2023 Accepting new patients
Lexington Health Inc Family Medicine Current Accepting new patients
Lexington Health Inc CurrentSince Aug 21, 2023 Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

109 Barton Creek Ct
Columbia, SC 29229
Phone (803) 256-2286

76 Polo Rd
Columbia, SC 29223
Phone (803) 699-7255

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

Interoperability endpoints

  • Direct secure messaging: kgordon11703@direct.lexmed.com

Organizations & group practices 5

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1558370346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 GREGG STREET",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012618",
            "telephone_number": "803-779-1420",
            "fax_number": "803-931-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 POLO RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292232806",
            "telephone_number": "803-699-7255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Medical Cir",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291693653",
            "country_code": "US",
            "telephone_number": "803-814-2288",
            "fax_number": "803-661-6280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KATHERINE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2000-00804",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "20286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "99563",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12645",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LICENSE",
            "identifier": "20286",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00399279",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912645",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgordon11703@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "205 Medical Cir",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291693653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgordon11703@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "205 Medical Cir",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291693653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.