Robert Gordon, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017845 Issued in CA

Practice address

1540 N Fuller Ave Apt 11
Los Angeles, CA 90046-7908

Phone

(213) 440-0353

NPI assigned

Jul 21, 2021

Last updated

Jul 21, 2021By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Anaheim Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Anaheim, CA
  • NPI 1962680033
  Medicare reassignment NPD
• Anaheim Urgent Care, Inc

  dba UrgentMed

  • Urgent Care Clinic/Center
  • Los Angeles, CA
  • NPI 1407423429
  NPD
• Anaheim Urgent Care, Inc

  dba Advanced Urgent Care of Beverly Hills

  • Urgent Care Clinic/Center
  • Beverly Hills, CA
  • NPI 1619682788
  NPD

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1821661489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 N FULLER AVE APT 11",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900467908",
            "telephone_number": "213-440-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 N FULLER AVE APT 11",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900467908",
            "telephone_number": "213-440-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ROBERT",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Christopher Gordon, MSW, ACSW
• Pierce Gordon
• Randall Arthur Gordon, D.M.D.
• Raul Gordon
• Risa Sherwood Gordon, MFT
• Robert John Gordon, MA
• Sandy Sarah Gordon
• Serenity Gordon
• Valerie Gordon, MSW
• Gordon's Grace LLC

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.