Michael Charles Gordon, MD

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

12691562-1205 Issued in UT

Practice address

5121 S Cottonwood St
Murray, UT 84107-5701

Phone

(801) 507-7400

Fax

(801) 507-7493

NPI assigned

Feb 26, 2006

Last updated

Mar 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, MT, UT, SD, IA5 enrollments

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.

Enrollment records 5

Specialty

Obstetrics/Gynecology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SCL Health Medical Group - Billings LLCGroup PAC ID 9638491574, 291 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 27)

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4
• Direct secure messaging: michael.gordon.1@17786.direct.athenahealth.com

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.

• SCL Health Medical Group - Billings LLC

  dba St Vincent Healthcare

  • Clinic/Center
  • Billings, MT
  • NPI 1508289703
  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Methodist Physician Practices, PLLC

  • Surgery Physician
  • San Antonio, TX
  • NPI 1922252717

  Family Medicine

  Medicare reassignment NPD
• Sanford Clinic

  dba Sanford Health Psychiatry & Psychology Clinic

  • Psychologist
  • Sioux Falls, SD
  • NPI 1396764254
  Medicare reassignment NPD
• Sanford Medical Center

  dba Edith Sanford Breast Specialty Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1093090342
  Medicare reassignment NPD
• University of Texas Health Science Center at San Antonio

  dba UT Health Physicians

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717

  Family Medicine

  Medicare reassignment NPD
• Central Iowa Hospital Corporation

  dba East Des Moines Family Care Center

  • Family Medicine Physician
  • Des Moines, IA
  • NPI 1104879576
  Medicare reassignment NPD (past)
• Central Montana Medical Facilities, Inc.

  dba Central Montana Medical Center Clinic

  • Family Medicine Physician
  • Lewistown, MT
  • NPI 1497868814
  Medicare reassignment
• Seven Oaks Women's Center PLLC

  • Obstetrics & Gynecology Physician
  • San Antonio, TX
  • NPI 1407984024
  Medicare reassignment
• Health Services Inc

  dba Layton Parkway Maternal Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Layton, UT
  • NPI 1457840175
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Central Iowa Hospital Corporation

  dba IMMC Outpatient Pharmacy

  • Pharmacy
  • Des Moines, IA
  • NPI 1003352949
  NPD

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

{
    "created_epoch": "1140912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1609842053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-7400",
            "fax_number": "801-507-7493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 North 29th Street",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591015100",
            "country_code": "US",
            "telephone_number": "406-238-2466",
            "fax_number": "406-238-2765",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 Sunnyview Ln Ste 103",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013128",
            "country_code": "US",
            "telephone_number": "406-257-3872",
            "fax_number": "406-758-7077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 W Thomas Rd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134295",
            "country_code": "US",
            "telephone_number": "602-406-7048",
            "fax_number": "602-406-7650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-26",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "K9548",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "AZ",
            "license": "64996",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MT",
            "license": "52364",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "TX",
            "license": "K9548",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "UT",
            "license": "12691562-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DEPTLHRevIntegrityHIMTechs@logan.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "210 Sunnyview Ln",
            "address_2": "Suite 103",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lillian H. Goodman, MD
• Samantha Goodrich, MASTERS OF SCIENCE
• Gordon C Jensen Inc
• Benjamin Hollis James Gordon, M.D.
• Landon Gordon
• Troy Michael Gorman, MD
• Jodie Gorney, LMT
• Jeffrey Alan Goss, APRN
• Whitney Goudjil
• Gourley Allergy & Asthma PC

• Maternal & Fetal Medicine Physician in Murray, UT
• Providers in Murray, UT by specialty
• Maternal & Fetal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.