Theodore B Gordon OD

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

2253 Issued in MA

Legal business name

THEODORE B GORDON OD

Practice address

354 Sewall St
Ludlow, MA 01056-2711

Phone

(413) 583-2260

Fax

(413) 583-3957

NPI assigned

Mar 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Theodore B Gordon, ODNPI 1568455962

Title

Owner /Optometrist

Phone

(413) 583-2260

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theodore Bennett Gordon, O.D.

  • Optometrist
  • Ludlow, MA
  • NPI 1568455962
  NPD (past) Authorized official

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1689844276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 SEWALL ST",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010562711",
            "telephone_number": "413-583-2260",
            "fax_number": "413-583-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 SEWALL ST",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010562711",
            "telephone_number": "413-583-2260",
            "fax_number": "413-583-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE B GORDON OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER /OPTOMETRIST",
        "authorized_official_telephone_number": "413-583-2260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MA",
            "license": "2253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Tavares, FNP-BC
• The Commonwealth of Massachusetts
• The Retreat of Boston LLC
• The Safe Space Studio LLC
• The Watch Wellness Group, Inc.
• Jismarlyn Torres Monegro
• Town of Ludlow (Ludlow Public Schools)
• Town of Ludlow
• Town of Ludlow
• Vickie J Verlinden, MD

• Eyewear Supplier in Ludlow, MA
• Providers in Ludlow, MA by specialty
• Eyewear Supplier in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.