Charles Robert Gordon, M.S., ATC, C.S.C.S

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

3910 Teays Valley Rd
Hurricane, WV 25526-9756

Phone

(304) 757-7293

Fax

(304) 757-0574

NPI assigned

May 14, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841405743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 223-1",
            "city": "RED HOUSE",
            "state": "WV",
            "postal_code": "251689663",
            "telephone_number": "304-550-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 TEAYS VALLEY RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269756",
            "telephone_number": "304-757-7293",
            "fax_number": "304-757-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CHARLES",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "M.S., ATC, C.S.C.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Bryan Given, DC
• Kevin D. Gladis, FNP-BC
• Linda M Goad, LPC
• Amanda Gollihue
• Christine M Gorby, PT, DPT, SCS, ATC
• Brian Michael Gray, PHARMD
• Dalton Michael Gray
• Kara Ann Gray
• Great Teays Medical Associates
• Great Teays Podiatry

• Athletic Trainer in Hurricane, WV
• Providers in Hurricane, WV by specialty
• Athletic Trainer in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.