Individual provider Active NPI

Gordon Thacker Connor, MD

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1801804703
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10818 Issued in AL
Practice address
2018 Brookwood Medical Center Dr
Professional Office Building Ste 209
Birmingham, AL 35209
Phone
(205) 877-2193
Fax
(205) 877-2196
NPI assigned
Aug 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10818 AL Primary

Addresses

Primary practice location

2018 Brookwood Medical Center Dr
Professional Office Building Ste 209
Birmingham, AL 35209

Mailing address

2018 Brookwood Medical Center Dr
Professional Office Building Ste 209
Birmingham, AL 35209
Phone (205) 877-2193

Other identifiers 1

IdentifierTypeStateIssuer
51086783OtherALBCBS OF AL INSURANCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040312001170 AL Practitioner - Internal Medicine 7113816570 Reassigns benefits to 2 organizations
Practice locations: Birmingham, AL

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Emory University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Management and Medical Services, LLCGroup PAC ID 4981504172, 5 clinicians

Practice addresses (Care Compare)

2018 Brookwood Medical Ctr Dr
Birmingham, AL 35209-6870
Phone (205) 877-2193

33637 US Hwy 280
Childersburg, AL 35044-3028
Phone (256) 378-3313

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10818ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Management and Medical Services, LLC CurrentSince Feb 16, 2004 Accepting new patients
Gordon T. Connor,M .D., LLC Internal Medicine CurrentSince Apr 1, 2026 Accepting new patients
Southern Orthopaedic Specialists, P.C. Past Accepting new patients

Locations

2018 Brookwood Medical Ctr Dr
Ste 209
Birmingham, AL 35209
Phone (205) 877-2193

33637 US Highway 280
Childersburg, AL 35044
Phone (205) 228-7600

34011 US Highway 280
Childersburg, AL 35044
Phone (256) 378-3313

Networks

  • bcbs alabama network 01H0
  • bcbs alabama network 01C0
  • bcbs alabama network 01I0
  • bcbs alabama network 01E0
  • bcbs alabama network 01A0
  • bcbs alabama network 01B0
  • bcbs alabama network 01G0

Organizations & group practices 3

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 5

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801804703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 BROOKWOOD MEDICAL CENTER DR",
            "address_2": "PROFESSIONAL OFFICE BUILDING STE 209",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-877-2193",
            "fax_number": "205-877-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 BROOKWOOD MEDICAL CENTER DR",
            "address_2": "PROFESSIONAL OFFICE BUILDING STE 209",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-877-2193",
            "fax_number": "205-877-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "GORDON",
        "middle_name": "THACKER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "10818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL INSURANCE",
            "identifier": "51086783",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.