Gordon Michael Telepun, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

17201 Issued in AL

Practice address

1206 Somerville Rd SE
Decatur, AL 35601

Phone

(256) 340-5188

Fax

(256) 340-5192

NPI assigned

Dec 5, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Decatur Neurology, PC

  • Neurology Physician
  • Decatur, AL
  • NPI 1457377913
  NPD

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1932267218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 SOMERVILLE RD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "35601",
            "telephone_number": "256-340-5188",
            "fax_number": "256-340-5192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 SOMERVILLE RD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "35601",
            "telephone_number": "256-340-5188",
            "fax_number": "256-340-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELEPUN",
        "first_name": "GORDON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AL",
            "license": "17201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000085141",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51085141TEL",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryann E Taylor, M.ED
• Ethan Michael Tease, HIS
• Teichmiller Vision Services LLC
• Chris Dewayne Teichmiller, O. D.
• Stephanie W Teichmiller, DMD
• Kristen D Telley, BA
• Terry Family Dentistry LLC
• Autumn S Terry, MSW
• Hannah Smith Terry, PHARM. D.
• Jada N Terry, RN

• Plastic and Reconstructive Surgery Physician in Decatur, AL
• Providers in Decatur, AL by specialty
• Plastic and Reconstructive Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.