Individual provider Active NPI

Anthony Scott Gordon, MD

  • Orthopaedic Surgery Physician
  • Sandy, UT
National Provider Identifier
1811983380
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2637671205 Issued in UT
Practice address
9844 S 1300 E
Ste 100
Sandy, UT 84094-4673
Phone
(801) 571-9433
Fax
(801) 572-5607
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2637671205 UT Primary

Addresses

Primary practice location

9844 S 1300 E
Ste 100
Sandy, UT 84094-4673

Mailing address

9844 S 1300 E
Ste 100
Sandy, UT 84094-4673
Phone (801) 571-9433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20051007000902 UT Practitioner - Orthopedic Surgery 5193759710 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2637671205UTMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Mar 24, 2010 Accepting new patients

Locations

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

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.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1811983380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9844 S 1300 E",
            "address_2": "STE 100",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944673",
            "telephone_number": "801-571-9433",
            "fax_number": "801-572-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9844 S 1300 E",
            "address_2": "STE 100",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944673",
            "telephone_number": "801-571-9433",
            "fax_number": "801-572-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ANTHONY",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "2637671205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

Verify at the official NPI Registry.