Jeffery S Gordon, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

11542 Issued in TN

Practice address

1300 Sawgrass Corporate Parkway
Ste 200
Sunrise, FL 33323-2823

Phone

(800) 243-3839

Fax

(855) 527-5510

NPI assigned

May 23, 2005

Last updated

Dec 16, 2016By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1770586919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552855",
            "telephone_number": "615-446-5121",
            "fax_number": "615-446-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SAWGRASS CORPORATE PARKWAY",
            "address_2": "STE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232823",
            "telephone_number": "800-243-3839",
            "fax_number": "855-527-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JEFFERY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD11542",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "11542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "4057650",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "370017664",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3179587",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scottlyn Goodman
• Steven David Goodman, D.C.
• Sean Michael Goodrum, CRNA
• Miranda Gopaul, 222Q00000X
• Chazeem Davaughn Gordon
• Julie Gordon, LCSW
• Roger Lee Gordon, M.D.
• St Christopher Augustus Gordon, DMD
• Suzette Gordon, LMHC
• Tiffany Michelle Gordon

• Hospitalist Physician in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Hospitalist Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; 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.