NPIMap

Individual provider Active NPI

Gordon P Laird, D.O.

  • Family Medicine Physician
  • Pawnee, OK
National Provider Identifier
1619954088
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1532 Issued in OK
Practice address
534 Illinois St
Pawnee, OK 74058-2036
Phone
(918) 762-3602
Fax
(918) 762-2952
NPI assigned
Dec 28, 2005
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 1532 OK
Surgery Physician 208600000X 1532 OK
Family Medicine Physician 207Q00000X 1532 OK Primary

Addresses

Primary practice location

534 Illinois St
Pawnee, OK 74058-2036

Mailing address

534 Illinois St
Pawnee, OK 74058-2036
Phone (918) 762-3602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20050301000114 OK Practitioner - Family PracticePractitioner - General Surgery 0749233963 Reassigns benefits to 1 organization
Practice locations: Pawnee, OK

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Surgery
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

534 Illinois St
Pawnee, OK 74058-2036
Phone (918) 762-3663

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1532OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gordon P. Laird, D.O. Inc Family Medicine CurrentSince Feb 5, 2014 Accepting new patients
Gordon P Laird,DO Family Medicine Current Accepting new patients
Blackwell Feet Plus, L.L.C. PastSince Jan 14, 2008 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Footcare & More LLC Past Accepting new patients
Heel to Toe Foot Care Plus Inc Past Accepting new patients
Pawnee Municipal Hospital Authority Past Accepting new patients
Feet Plus Solutions Inc Past Accepting new patients

Locations

534 Illinois St
Pawnee, OK 74058
Phone (918) 762-2573

Organizations & group practices 8

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 5

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1619954088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 ILLINOIS ST",
            "city": "PAWNEE",
            "state": "OK",
            "postal_code": "740582036",
            "telephone_number": "918-762-3602",
            "fax_number": "918-762-2952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 ILLINOIS ST",
            "city": "PAWNEE",
            "state": "OK",
            "postal_code": "740582036",
            "telephone_number": "918-762-3602",
            "fax_number": "918-762-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIRD",
        "first_name": "GORDON",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OK",
            "license": "1532",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "1532",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "1532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawnee, OK

Sources for this page

Verify at the official NPI Registry.