Michael D Gordon DD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

10462 MICHAEL D GORD Issued in KS

Legal business name

MICHAEL D GORDON DD PA

Practice address

701 N Goddard Road
Goddard, KS 67052

Phone

(316) 794-7800

Fax

(316) 794-7801

NPI assigned

Sep 20, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael D Gordon, ODNPI 1699870212

Title

President

Phone

(316) 684-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael D Gordon, OD

  • Optometrist
  • Wichita, KS
  • NPI 1699870212
  Authorized official Same address or phone

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871690073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "GODDARD",
            "state": "KS",
            "postal_code": "67052",
            "telephone_number": "316-794-7800",
            "fax_number": "316-794-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N GODDARD ROAD",
            "city": "GODDARD",
            "state": "KS",
            "postal_code": "67052",
            "telephone_number": "316-794-7800",
            "fax_number": "316-794-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D GORDON DD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-684-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "10462 MICHAEL D GORD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "065096",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie McClellan, DPT
• Catherine L Meadows
• Medicalodges, Inc. (Medicalodges Goddard)
• Medicalodges, Inc. (Medicalodges Goddard)
• Meister, Inc. (Kombo Pharmacy)
• Midwest Building Suppy, Inc
• ML-Op Goddard LLC
• Morgan Integrative Nutrition & Wellness LLC
• Kate E Morgan, RD
• Move Pediatric Therapy, LLC

• Optometrist in Goddard, KS
• Providers in Goddard, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.