Richard Allen Gordon, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

11805 Issued in OK

Practice address

7600 S Lewis Ave
Tulsa, OK 74136-6836

Phone

(918) 493-2229

Fax

(918) 493-7819

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

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

Interoperability endpoints

• Direct secure messaging: rgordon113444@ahs.direct-ci.com
• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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.

• Ahs Oklahoma Physician Group LLC

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775

  OK, Pediatrics

  Medicare reassignment NPD
• Ahs Oklahoma Physician Group, LLC

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051
  NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1972557585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366836",
            "telephone_number": "918-493-2229",
            "fax_number": "918-493-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366836",
            "telephone_number": "918-493-2229",
            "fax_number": "918-493-7819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "11805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100088660B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gloria Nicole Gordon
• Jay M. Gordon, R. N.
• Kevin Gordon
• Maureen Ann Gordon
• Nicole Lynette Gordon
• Ryann Gordon
• Sherri M Gordon, M D
• Sophia Camille Gordon
• Vanayshia Boo Gordon
• William Jacob Gordon, MSW

• All providers in Tulsa, OK
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; 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.