STEPHANIE H GORDON (NPI# 1407849722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407849722 |
| Entity Type | Individual |
| Full Name | STEPHANIE H GORDON |
| Credential | M.D. |
| Practice Address |
2750 Owens Rd Sw Suite A Conyers GA 30094-3991 |
| Practice Telephone | 6784134644 |
| Practice Fax Number | 6784134624 |
| Mailing Telephone | 6784134644 |
| Mailing Fax Number | 6784134624 |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2012-08-06 |
| NPI Deactivation Date | 03/27/2006 |
| NPI Reactivation Date | 2006-04-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
049382 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 551117710A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578970968 | Stephanie Gordon | Specialist/Technologist | 198 Heather Dr, Central, SC 29630-9308 | 2014-07-17 |
| 1619309945 | Stephanie Jean Gordon | Acupuncturist | 410 Wabash St, Michigan City, IN 46360-3334 | 2013-08-09 |
| 1629376835 | Stephanie Vicky Gordon | Massage Therapist | 2874 Shelby St, Suite 108, Bartlett, TN 38134-4579 | 2011-03-11 |
| 1750516159 | Stephanie Spurlock Gordon | Dental Hygienist | 1245 Nw 119th St, Miami, FL 33167-3231 | 2009-05-29 |
| 1366564288 | Stephanie Ward Gordon | Pharmacist | 7880 Winn Rd, Spring Grove, IL 60081-9687 | 2007-04-03 |
| 1386121366 | Stephanie Gordon | Dentist | 736 E Oak St, Oakland, MD 21550-1615 | 2018-07-23 |
| 1356864110 | Stephanie Christine Gordon | Licensed Practical Nurse | 2216 20th St, Zion, IL 60099-1648 | 2017-07-24 |
| 1174992127 | Stephanie Gordon | Advanced Practice Midwife | 611 W Park St, Urbana, IL 61801-2529 | 2015-09-21 |
| 1003234840 | Stephanie Gordon | Social Worker | 1900 S Acadian Thruway, Baton Rouge, LA 70808-1665 | 2014-03-30 |
| 1841500840 | Stephanie Marie Gordon | Behavioral Analyst | 4343 Williamsbourgh Dr, Sacramento, CA 95823-2006 | 2010-10-12 |
| Street Address |
2750 OWENS RD SW SUITE A |
| City | CONYERS |
| State | GA |
| Zip Code | 30094-3991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548569502 | Megan M Wandurraga | Nurse Practitioner | 2750 Owens Rd Sw, Ste A, Conyers, GA 30094-3991 | 2011-03-16 |
| 1871654624 | The Womens Center PC | Obstetrics & Gynecology | 2750 Owens Rd Sw, Suite A, Conyers, GA 30094-3991 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
| 1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
| 1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
| 1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
| Find all providers in zip 30094 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1639216450 | Holly Anne Imlach | Obstetrics & Gynecology | 1380 Milstead Ave Ne, Suite E, Conyers, GA 30012-3864 | 2007-01-31 |
| 1871654624 | The Womens Center PC | Obstetrics & Gynecology | 2750 Owens Rd Sw, Suite A, Conyers, GA 30094-3991 | 2006-12-13 |
| 1205943743 | Thomas Lewis Lyons | Obstetrics & Gynecology | 1380 Milstead Ave Ne, Suite E, Conyers, GA 30012-3864 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558998070 | Gynecology Associates of Georgia | Obstetrics & Gynecology | 101 St Josephs Candler Dr Ste 300, Pooler, GA 31322-9588 | 2020-03-25 |
| 1295360949 | Premier Women's Gyn, LLC | Obstetrics & Gynecology | 101 Yorktown Dr Ste 224, Fayetteville, GA 30214-1578 | 2020-03-03 |
| 1073074175 | Mobile Md, LLC | Obstetrics & Gynecology | 746 Royal Springs Ln, Grovetown, GA 30813-4534 | 2019-03-29 |
| 1528565785 | Schilling Cosmetic Surgery & Aesthetics, LLC | Obstetrics & Gynecology | 1757 Rock Quarry Rd Ste A, Stockbridge, GA 30281-7303 | 2018-04-12 |
| 1356870547 | Her Wellness Center, LLC | Obstetrics & Gynecology | 1763 Highway 196 W, Hinesville, GA 31313-8013 | 2017-06-09 |
| 1245769777 | Better Health Better Life LLC | Obstetrics & Gynecology | 2398 Mount Vernon Rd Ste 150, Dunwoody, GA 30338-3064 | 2017-06-08 |
| 1699115451 | Jeffrey Alan Bernstein | Obstetrics & Gynecology | 655 Widgeon Lane, Atlanta, GA 30327 | 2013-06-26 |
| 1376899179 | Earl Edwin Sands | Obstetrics & Gynecology | 2200 Blackheath Trce, Alpharetta, GA 30005-6978 | 2012-07-30 |
| 1063788784 | Joseph Rudolph Prine Sr. | Obstetrics & Gynecology | 1216 Chennault Dr, Dublin, GA 31021-3006 | 2012-03-27 |
| 1871865113 | Candace Marvenia Tillman | Obstetrics & Gynecology | 477 Windsor St. Sw, Ste. 309, Atlanta, GA 30312 | 2012-02-02 |
| Find all providers with the same taxonomy | ||||
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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.