Otis T Gordon, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

E-4082 Issued in AR

Practice address

415 N University Ave
Little Rock, AR 72205-3108

Phone

(501) 666-0249

Fax

(501) 666-4340

NPI assigned

Apr 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Gastroenterology

Education

Emory University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI-St Vincent Infirmary Hospital, Little Rock, AR, CCN 040007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ogordon468689@direct.stlukeshealth.org
• Direct secure messaging: otis.gordon@svmgs.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Vincent Medical Group

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1134176480

  Gastroenterology

  Medicare reassignment Care Compare group NPD
• Endoscopy Center of Arkansas Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
  • NPI 1497267702
  NPD
• St Vincent Physician Clinics LLC

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1134558398
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Vincent Infirmary Medical Center

  • Psychiatric Hospital Unit
  • Little Rock, AR
  • NPI 1710442801
  Care Compare affiliation
• St Vincent Infirmary Medical Center

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1780684431
  Care Compare affiliation

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1851355218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053108",
            "telephone_number": "501-666-0249",
            "fax_number": "501-666-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053108",
            "telephone_number": "501-666-0249",
            "fax_number": "501-666-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "OTIS",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AR",
            "license": "E4082",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AR",
            "license": "E-4082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5N145",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Houston Gordon, MD
• Jaclyn Gordon, DO
• Katrena L Gordon, NP
• Kori Raymer Gordon
• Mia Emily Gordon, LPC
• Andrea Leigh Gore
• Michalee Gore, CRNA
• Rhett Christopher Gore, D.C.
• Richard Lloyd Gore, D.D.S.
• Sean Zachary Gore, D.D.S.

• Gastroenterology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Gastroenterology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.