Active NPI
Andrew G Gordon, MD
- Internal Medicine Physician
- Annapolis, MD
National Provider Identifier
1801982277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D31997
- Practice address
- 2003 Medical Parkway
Suite 100
Annapolis, MD 21401 - Phone
- (410) 573-1110
- Fax
- (410) 266-0714
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D31997 | MD | Primary |
Addresses
Primary practice location
2003 Medical Parkway
Suite 100
Annapolis, MD 21401
Mailing address
2003 Medical Parkway
Suite 100
Annapolis, MD 21401
Phone (410) 573-1110
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 409621500 | Medicaid | MD | |
| 0401032 | Other | UNITED HEALTHCARE | |
| 1496254 | Other | UNITED MINE WORKERS ASSOC | |
| 110018449 | Other | MEDICARE RAILROAD | |
| P11669 | Other | BCBS POINT OF SERVICE | |
| 0002 | Other | DC | BCBS |
| 260082 | Other | MAMSI | |
| 41439701 | Other | MD | BCBS |
| 4141276 | Other | AETNA | |
| P0217 | Other | PRINCIPLE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D31997 | MD | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265155200000",
"number": "1801982277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2003 MEDICAL PARKWAY",
"address_2": "SUITE 100",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "21401",
"telephone_number": "410-573-1110",
"fax_number": "410-266-0714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2003 MEDICAL PARKWAY",
"address_2": "SUITE 100",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "21401",
"telephone_number": "410-573-1110",
"fax_number": "410-266-0714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "ANDREW",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2010-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D31997",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "409621500",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0401032",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED MINE WORKERS ASSOC",
"identifier": "1496254",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "110018449",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS POINT OF SERVICE",
"identifier": "P11669",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0002",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "260082",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "41439701",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4141276",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRINCIPLE",
"identifier": "P0217",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.