NPIMap

Individual provider Active NPI

Robert Gordon Merck

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1669009478
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3536 Issued in SC
Practice address
905 Verdae Blvd Ste 101
Greenville, SC 29607-4098
Phone
(864) 990-1910
Fax
(864) 990-1911
NPI assigned
Mar 24, 2020
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MPA.3536 SC
Physician Assistant 363A00000X 3536 SC Primary

Addresses

Primary practice location

905 Verdae Blvd Ste 101
Greenville, SC 29607-4098

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8614

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL EPIC Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200915000076 SC Practitioner - Physician Assistant 5395163901 Reassigns benefits to 3 organizations
I20250527002655 NC Practitioner - Physician Assistant 5395163901 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keowee Primary Care and Internal Medicine PCGroup PAC ID 2860472743, 11 clinicians

Practice addresses (Care Compare)

109 Carter Park Dr
3A
Seneca, SC 29678-1152
Phone (864) 885-0058

57 White Owl LN
Cashiers, NC 28717-4514
Phone (828) 743-2491

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3536SCMDDentist
MPA.3536SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Ambulatory Services - St. Francis, LLC CurrentSince Jan 15, 2024 Accepting new patients
Mountain Area Family Medicine, PA Current Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince Jun 16, 2025 Accepting new patients
Woodruff Road Urgent Care Center, P.C. Current Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince Jun 16, 2025 Accepting new patients
MH Highlands-Cashiers Medical Center, LLLP CurrentSince Jul 4, 2025 Accepting new patients
Highlands-Cashiers Physician Services, Inc. Physician Assistant Current Accepting new patients
MH Highlands-Cashiers Medical Center, LLLP Current Accepting new patients
Medi Urgent Care Center Inc Past Accepting new patients

Locations

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

57 White Owl Ln
Cashiers, NC 28717
Phone (828) 743-2491

1467 Woodruff Rd
Ste C
Greenville, SC 29607
Phone (864) 458-8126

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 12

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 3

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1669009478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 VERDAE BLVD STE 101",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074098",
            "telephone_number": "864-990-1910",
            "fax_number": "864-990-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCK",
        "first_name": "ROBERT",
        "middle_name": "GORDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "MPA.3536",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "Epic software",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "103 Omni Dr Ste B",
            "city": "Seneca",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296729448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.