Kilbourn Gordon III, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

038689 Issued in CT

Practice address

220 Route 12
Groton, CT 06340-3414

Phone

(860) 650-3848

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Emergency MedicineAlso: General Practice

Education

New York Medical College, 1983

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Urgent Care Medical Associates, LLC

  • Urgent Care Clinic/Center
  • Brookfield, CT
  • NPI 1730479254
  Medicare reassignment
• WRK Ventures, LLC

  • Urgent Care Clinic/Center
  • Southbury, CT
  • NPI 1194993980
  NPD

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1952455693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 ROUTE 12",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403414",
            "telephone_number": "860-650-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ROUTE 12",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403414",
            "telephone_number": "860-650-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KILBOURN",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "038689",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CT",
            "license": "038689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul S. Goldstein, OTR/L
• Hector Salvador Gonzalez, IDC
• Oscar Antonio Gonzalez
• Zuliam Ivelisee Gonzalez
• Vernon Goodwin
• George K Grant, IDC
• Adam S Green
• Ann Green, PT
• Bryar Taylor Green
• Danielle Green, DMD

• General Practice Physician in Groton, CT
• Providers in Groton, CT by specialty
• General Practice Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.