BRADLEY GORDAN (NPI# 1134562762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134562762 |
| Entity Type | Individual |
| Full Name | BRADLEY GORDAN |
| Credential | D.O. |
| Practice Address |
202 10th St Se Cedar Rapids IA 52403 |
| Mailing Address |
202 10th St Se Cedar Rapids IA 52403-2414 |
| Practice Telephone | 3193625118 |
| Mailing Telephone | 3193625118 |
| Enumeration Date | 2013-04-13 |
| Last Update Date | 2019-06-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | DO-05396 | IA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 293357 | NY | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 1134562762 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Baystate Medical Ctr, 759 Chestnut Street, Springfield, MA 011990001 | 4137940000 | |
| 1000 South Ave, Rochester, NY 14620 | 5853410366 |
| Street Address |
202 10TH ST SE |
| City | CEDAR RAPIDS |
| State | IA |
| Zip Code | 52403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326045600 | Hugh Philip Macmenamin | Orthopaedic Surgery | 202 10th St Se, Cedar Rapids, IA 52403-2404 | 2005-07-01 |
| 1598304065 | Justin Kreiter | Physical Therapist | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2020-01-02 |
| 1346889813 | Elizabeth Brown | Physical Therapist | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2020-01-02 |
| 1922666585 | Courtney M Lansing | Audiologist | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2019-05-30 |
| 1740745538 | Annette Keller Qualben | Registered Nurse | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2019-02-05 |
| 1790256048 | Jenny Lynn Botsford | Nurse Practitioner | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2018-12-16 |
| 1790288397 | Amber Arthurs | Nurse Practitioner | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2018-03-10 |
| 1033645189 | Mina Soleimani | Family Medicine | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2017-05-11 |
| 1962934877 | Pruchno Medicine LLC. / Health Transitions Clinic | Dietary Manager | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2017-03-30 |
| 1871034686 | Brandey Cordes | Audiologist | 202 10th St Se, Suite 200, Cedar Rapids, IA 52403-2414 | 2017-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093242083 | Eric Burton | Social Worker | 1535 1st Ave Se., Cedar Rapids Va Cboc, Cedar Rapids, IA 52403 | 2017-05-22 |
| 1619404613 | Dylan Roberts Streb | Family Medicine | Eastern Iowa Health Center, 1201 Third Avenue Se, Cedar Rapids, IA 52403 | 2017-05-22 |
| 1760870851 | Forefront Dermatology, S.c. | Dermatology | 202 10th Street, Sw, Suite 290, Cedar Rapids, IA 52403 | 2014-12-26 |
| 1801292883 | Laura Pelechek | Marriage & Family Therapist | 1744 2nd Ave Se, Cedar Rapids, IA 52403 | 2014-11-18 |
| 1306090147 | John Daniel Schuchmann | Anesthesiology | 3629 Random Road Se, Cedar Rapids, IA 52403 | 2008-11-06 |
| 1851564157 | Cedar Rapids Medical Education Foundation | Family Medicine | 1260 Second Avenue S.e., Cedar Rapids, IA 52403 | 2008-04-08 |
| 1093866071 | Mcld Corporation | Durable Medical Equipment & Medical Supplies | 207 2nd Avenue Se Ste A, Cedar Rapids, IA 52403 | 2007-01-16 |
| 1154483980 | James P Schuller | Dentist | 1000 42nd St Se, 1000 Professional Centre Suite B, Cedar Rapids, IA 52403 | 2006-12-15 |
| 1477640183 | C R Iv Service Inc | Home Health | 402 10th St, Ste 700 Carepro Home Health, Cedar Rapids, IA 52403 | 2006-10-06 |
| 1104919638 | C R Iv Service Inc | Durable Medical Equipment & Medical Supplies | 402 10th Street Se, Suite 700, Cedar Rapids, IA 52403 | 2006-10-02 |
| Find all providers in zip 52403 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912153321 | William Amin Audeh | Surgery | 3846 Lost Valley Road Se, Cedar Rapids, IA 52403-2008 | 2008-08-18 |
| 1114390358 | State University of Iowa | Surgery | 3705 River Ridge Dr Ne, Cedar Rapids, IA 52402-7596 | 2015-11-10 |
| 1497048805 | Takintope Akinbiyi | Surgery | 3705 River Ridge Dr Ne, Cedar Rapids, IA 52402-7596 | 2011-05-18 |
| 1952612616 | Patrick J Hawkes | Surgery | 3705 River Ridge Dr Ne, Cedar Rapids, IA 52402 | 2010-06-28 |
| 1932338837 | Jared Kray | Surgery | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2009-07-13 |
| 1144474370 | Vincent Junior Reid | Surgery | 701 10th St Se, Cedar Rapids, IA 52403-1251 | 2008-11-14 |
| 1528277563 | Kerri Ann Nowell | Surgery | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2007-05-22 |
| 1538378591 | Nora A Royer | Surgery | 788 8th Ave Se, Suite 300, Cedar Rapids, IA 52401-2107 | 2007-05-22 |
| 1851500995 | Andrew George Nowell | Surgery | 202 10th Street Se, Cedar Rapids, IA 52403-2404 | 2007-05-22 |
| 1437209137 | Physicians' Clinic of Iowa, PC, Dept of Surgical Specialists | Surgery | 830 4th Ave Se, Cedar Rapids, IA 52403-2423 | 2007-01-12 |
| Find all providers in CEDAR RAPIDS | ||||
| City | CEDAR RAPIDS |
| Zip Code | 52403 |
Please comment or provide details below to improve the information on BRADLEY GORDAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.