Active NPI
Ronald F Gordon, M.D.
- Otolaryngology Physician
- Ogden, UT
National Provider Identifier
1619082799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- Practice address
- 3955 Harrison Blvd Ste U5
Ogden, UT 84403-2398 - Phone
- (801) 627-1363
- Fax
- (801) 627-4744
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | UT | Primary |
Addresses
Primary practice location
3955 Harrison Blvd Ste U5
Ogden, UT 84403-2398
Mailing address
3955 Harrison Blvd Ste U5
Ogden, UT 84403-2398
Phone (801) 627-1363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16331-1205 | UT | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619082799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3955 HARRISON BLVD STE U5",
"city": "OGDEN",
"state": "UT",
"postal_code": "844032398",
"telephone_number": "801-627-1363",
"fax_number": "801-627-4744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3955 HARRISON BLVD STE U5",
"city": "OGDEN",
"state": "UT",
"postal_code": "844032398",
"telephone_number": "801-627-1363",
"fax_number": "801-627-4744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "RONALD",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "UT",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- 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.