Scott David Gordon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1999 Issued in NC

Practice address

225 E Lee Ave
Yadkinville, NC 27055

Phone

(336) 679-2931

Fax

(336) 677-6486

NPI assigned

May 3, 2006

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yadkin Vision Center O.D., PLLCGroup PAC ID 7012071574, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Yadkin Vision Center O.D., PLLC

  • Optometrist
  • Yadkinville, NC
  • NPI 1487807616
  Medicare reassignment Care Compare group NPD Authorized official
• Yadkin Vision Center O.D., PLLC

  • Optometrist
  • East Bend, NC
  • NPI 1932353976
  NPD Authorized official
• Yadkin Vision Center, OD PA

  • Optometrist
  • East Bend, NC
  • NPI 1568402741
  NPD (past)
• Yadkin Vision Center, OD PA

  • Optometrist
  • Yadkinville, NC
  • NPI 1790731305
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1598723934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E LEE AVE",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270558227",
            "telephone_number": "336-679-2931",
            "fax_number": "336-677-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E LEE AVE",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "27055",
            "telephone_number": "336-679-2931",
            "fax_number": "336-677-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - YADKINVILLE",
            "identifier": "2474038C",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OE TRACKER",
            "identifier": "525320",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1598723934",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OD LICENSE",
            "identifier": "1999",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - EAST BEND",
            "identifier": "2474038D",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908096",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gaston Family Health Services, Inc
• Gaston Family Health Services, Inc.
• Shawnte Gates, M.S NCC LPCA
• Keri Smith Gaylord, LCSW
• Gail C Gordon, O.D.
• Lisa Hartley Greene, PTA
• Charles B Gross
• Courtney Guido, LCSW
• Cheryl Lynn Guinn, PTA
• Nicholas Leo Gullett, PHARMD

• Optometrist in Yadkinville, NC
• Providers in Yadkinville, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.