NPIMap

Organization Active NPI

Chrisanne Gordon, MD

  • Rehabilitation Clinic/Center
  • Marysville, OH
National Provider Identifier
1962896969
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
35042915 Issued in OH
Legal business name
CHRISANNE GORDON, MD
Practice address
500 London Avenue
Marysville, OH 43040
Phone
(937) 578-2255
NPI assigned
Mar 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Authorized official

Name
Chrisanne Gordon, MDNPI 1386678688
Title
Physician
Phone
(937) 578-2255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X 35042915 OH Primary

Addresses

Primary practice location

500 London Avenue
Marysville, OH 43040

Mailing address

6724 Perimeter Loop Rd.
PMB #317
Dublin, OH 43017

Other identifiers 1

IdentifierTypeStateIssuer
0707328MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1962896969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6724 PERIMETER LOOP RD.",
            "address_2": "PMB #317",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "43017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LONDON AVENUE",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "43040",
            "telephone_number": "937-578-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISANNE GORDON, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "CHRISANNE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "937-578-2255",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "OH",
            "license": "35042915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0707328",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.