John C Gordon MD PA

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

Legal business name

JOHN C GORDON MD PA

Practice address

6830 Hospital Dr
Suite 202
Baltimore, MD 21237-4373

Phone

(301) 574-0077

Fax

(301) 574-0884

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Jeannine Wills

Title

Manager

Phone

(410) 574-0077

Specialties & licenses 1

Addresses

Other names 1

• Eastern Sports Medicine & Orthopaedic Center Other name

Practitioners 1

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

• Dorsey Fletcher Butterbaugh, PAC

  • Physician Assistant
  • Bel Air, MD
  • NPI 1821015348
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790903631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6830 HOSPITAL DR",
            "address_2": "SUITE 202",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374373",
            "telephone_number": "301-574-0077",
            "fax_number": "301-574-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6830 HOSPITAL DR",
            "address_2": "SUITE 202",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374373",
            "telephone_number": "301-574-0077",
            "fax_number": "301-574-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C GORDON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLS",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "410-574-0077"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Sports Medicine & Orthopaedic Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Herman Singh Johal, MD MPH FRCSC
• Jagdeep Nicki Kaur Johal, CRNP
• Michelle Johansen, M.D.
• Johmab Family Preservation Services
• John Braxton MD
• John C. Fiastro, D.D.S.
• John Charlton Podiatry PA
• John J Loh ,D. O.,P a
• John Mansung Lee,M.D.
• John P. Miller, M.D.

• Pediatric Orthopaedic Surgery Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatric Orthopaedic Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.