CARRIE A GORDON (NPI# 1215020755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215020755 |
| Entity Type | Individual |
| Full Name | CARRIE A GORDON |
| Credential | MD |
| Practice Address |
887 Congress St. Suite 320 Portland ME 04102 |
| Mailing Address |
190 Riverside St Suite 6b Portland ME 04103-1073 |
| Practice Telephone | 2076625522 |
| Practice Fax Number | 2076625527 |
| Mailing Telephone | 2076212000 |
| Mailing Fax Number | 2076612033 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2017-04-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | MD16227 | ME | Allopathic & Osteopathic Physicians |
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
MD16227 | ME | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 407810099 | 05 | |
| NH | 30204313 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134511769 | Carrie Justina Gordon | Physical Therapy Assistant | 1204 Frye St, Athens, TN 37303-3052 | 2015-02-18 |
| 1134498926 | Carrie Kallenbach Gordon | Nurse Practitioner | 300 Bradford Street, Maguire Correctional Facility, Redwood City, CA 94063 | 2011-12-22 |
| 1144383415 | Carrie Katz Gordon | Physical Therapist | 100 E Irving Park Rd, St 107, Roselle, IL 60172-2048 | 2006-12-18 |
| 1992772644 | Carrie Ann Gordon | Obstetrics & Gynecology | 4860 Y St, Ob/gyn, Suite 2500, Sacramento, CA 95817-2307 | 2006-03-01 |
| Street Address |
887 CONGRESS ST. SUITE 320 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184718694 | Brad Cushing | Surgery | 887 Congress St., Portland, ME 04102 | 2006-10-02 |
| 1346320538 | Robert J Winchell | Surgery | 887 Congress St., Portland, ME 04106 | 2006-10-16 |
| 1215023973 | Julianne B Ontengco | Nurse Practitioner | 887 Congress St., Portland, ME 04102 | 2006-10-04 |
| 1780779132 | David L Ciraulo | Surgery | 887 Congress St., Suite 210, Portland, ME 04102 | 2006-10-03 |
| 1841385440 | Gretchen L Arnold | Dietitian, Registered | 887 Congress St., Suite 320, Portland, ME 04102 | 2006-10-03 |
| 1568557916 | David E Clark | Surgery | 887 Congress St., Portland, ME 04102 | 2006-10-03 |
| 1154415586 | Judith C Kerr | Nurse Practitioner | 887 Congress St., Portland, ME 04102 | 2006-10-02 |
| 1023102449 | Virginia A Eddy | Surgery | 887 Congress St., Portland, ME 04102 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| Taxonomy Code | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194042481 | Ronald Zviti | Pediatrics | 887 Congress St Ste 300, Portland, ME 04102-3103 | 2010-04-26 |
| 1801098108 | Northwest Pediatric Kidney Specialists LLC | Pediatrics | 1935 Nw Norfolk Ct, Portland, OR 97229-8448 | 2007-05-31 |
| 1164646485 | Sharon W Su | Pediatrics | 501 N Graham St, Suite 315, Portland, OR 97227 | 2007-04-11 |
| 1699877258 | Jeanne Mowry | Pediatrics | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2006-09-03 |
| 1881600336 | David Joel Rozansky | Pediatrics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-08-01 |
| 1780699280 | Amira Al-uzri | Pediatrics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-07-31 |
| 1710955018 | Edward Nigel Guillery | Pediatrics | 501 N Graham St, Suite 340, Portland, OR 97227-1654 | 2006-03-10 |
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| 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.