Thomas Gordon, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

2012026227 Issued in MO

Practice address

12921 Enterprise Way
Bridgeton, MO 63044-1206

Phone

(314) 344-9604

NPI assigned

Jul 11, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Schnuck Markets Inc

  • Community/Retail Pharmacy
  • Bridgeton, MO
  • NPI 1841508041
  NPD (past)

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1770069916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 PARIS DR",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620351617",
            "telephone_number": "618-610-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12921 ENTERPRISE WAY",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630441206",
            "telephone_number": "314-344-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "THOMAS",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.295883",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2012026227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Glotta, DPT
• Anoj Kumar Goel, M.D.
• Charles Gonzales, M.D.
• Molly Goodman, NP
• Stacie Gorden
• Mary Jo Gorman, M.D.
• Bryan John Goss, ACNP
• Thomas Michael Gotsis, DDS
• Kaitlyn Taylor Kristina Gotthardt
• Taryn Lorraine Gough

• Pharmacist in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.