NPIMap

Individual provider Active NPI

Shawn R Gorden, M.D.

  • Obstetrics & Gynecology Physician
  • Manchester, KY
National Provider Identifier
1851482947
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
39057 Issued in KY
Practice address
56 Marie Langdon Dr
Manchester, KY 40962-6329
Phone
(606) 599-4080
Fax
(606) 598-1688
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 39057 KY
Obstetrics & Gynecology Physician 207V00000X L3666 TX
Obstetrics & Gynecology Physician 207V00000X 39057 KY Primary

Addresses

Primary practice location

56 Marie Langdon Dr
Manchester, KY 40962-6329

Mailing address

509 Memorial Dr Ste 2
Manchester, KY 40962-6196
Phone (606) 598-5104

Other identifiers 4

IdentifierTypeStateIssuer
64091820MedicaidKY
215019501MedicaidTX
11356327OtherCAQH ID
2552545MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041117000273 KY Practitioner - Obstetrics/Gynecology 2466416011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Georgia School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital, Inc. 60 clinicians

Practice addresses (Care Compare)

210 Marie Langdon Dr
Manchester, KY 40962-6388

56 Marie Langdon Dr
Manchester, KY 40962-6329
Phone (606) 599-4080

Hospital & facility affiliations

  • AdventHealthManchester Hospital, Manchester, KY, CCN 180043

Merit-based Incentive Payment System (MIPS)

Final score
98.63 of 100Reported as group
Quality
81.08
Promoting interoperability
100
Improvement activities
40
Cost
81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L3666TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital, Inc. CurrentSince Oct 20, 2017 Accepting new patients
Memorial Hospital, Inc. Current Accepting new patients
Memorial Hospital Inc. Obstetrics & Gynecology CurrentSince Oct 20, 2017 Accepting new patients
Planned Parenthood Center of El Paso Obstetrics & Gynecology Past Accepting new patients
Memorial Hospital, Inc. Past Accepting new patients
SPMG Signature Pampa Medical Group PastSince Sep 23, 2015 Accepting new patients
El Paso Center for Women'S Health P.a. Obstetrics & Gynecology PastSince Jul 11, 2011 Accepting new patients
Shawn Gorden MD PSC PastSince Nov 1, 2004 Accepting new patients
Shawn Gorden MD, PSC Obstetrics & Gynecology Past Accepting new patients

Locations

210 Marie Langdon Dr
Manchester, KY 40962
Phone (865) 985-7047

509 Memorial Dr
Ste 2
Manchester, KY 40962
Phone (606) 598-4384

1033 N Highway 11
Manchester, KY 40962
Phone (606) 598-6163

Interoperability endpoints

  • Direct secure messaging: sgorden938249@adventhealth.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Adventhealth ManchesterManchester, KY, CCN 180043 Hospital Corporate Director Dec 12, 2024
Adventhealth ManchesterBeverly, KY, CCN 183484 Rural health clinic Corporate Director Jan 1, 2025
Adventhealth Daniel Boone ClinicBarbourville, KY, CCN 188574 Rural health clinic Corporate Director Jan 1, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1851482947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MEMORIAL DR STE 2",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626196",
            "telephone_number": "606-598-5104",
            "fax_number": "606-598-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 MARIE LANGDON DR",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409626329",
            "telephone_number": "606-599-4080",
            "fax_number": "606-598-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDEN",
        "first_name": "SHAWN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "KY",
            "license": "39057",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "L3666",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "39057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64091820",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215019501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "11356327",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2552545",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, KY

Sources for this page

Verify at the official NPI Registry.