MR. ODELL DELROY GORDON (NPI# 1659784809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659784809 |
| Entity Type | Individual |
| Full Name | MR. ODELL DELROY GORDON |
| Credential | NP |
| Practice Address |
40 Hurley Ave Suite 4 Kingston NY 12401-3739 |
| Practice Telephone | 8453385600 |
| Practice Fax Number | 8453383058 |
| Mailing Telephone | 8453385600 |
| Mailing Fax Number | 8453383058 |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2020-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F338818-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
40 HURLEY AVE SUITE 4 |
| City | KINGSTON |
| State | NY |
| Zip Code | 12401-3739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730178377 | Kalyan R. Venkat | Surgery | 40 Hurley Ave, Suite 17, Kingston, NY 12401-3739 | 2005-10-17 |
| 1912565359 | Molly Young | Nurse Practitioner | 40 Hurley Ave, Kingston, NY 12401-3739 | 2019-05-31 |
| 1871087676 | Jennifer Marie Hoben | Nurse Practitioner | 40 Hurley Ave, Kingston, NY 12401-3739 | 2018-06-15 |
| 1255683603 | Jill Marie Tschinkel | Nurse Practitioner | 40 Hurley Ave, Suite 4, Kingston, NY 12401-3739 | 2012-10-10 |
| 1346559622 | B. Kapila, P.C. | Otolaryngology | 40 Hurley Ave, Suite 15, Kingston, NY 12401-3739 | 2010-10-04 |
| 1043521511 | Donna Jean Hannigan | Nurse Practitioner | 40 Hurley Ave, Kingston, NY 12401-3739 | 2010-06-29 |
| 1821259615 | Mid-valley Comprehensive Ob-gyn PC | Obstetrics & Gynecology | 40 Hurley Ave, Kingston, NY 12401-3739 | 2008-06-24 |
| 1154522316 | Samuel Pai | Dentist | 40 Hurley Ave, Suite 6, Kingston, NY 12401-3739 | 2007-05-29 |
| 1194934786 | Paul Pai | Dentist | 40 Hurley Ave, Kingston, NY 12401-3739 | 2007-05-21 |
| 1386765303 | Darryl Leong | Physical Therapist | 40 Hurley Ave, Suite 4, Kingston, NY 12401-3739 | 2007-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215565783 | Health Quest Medical Practice, PC | Surgery | 1240 Ulster Avenue--breast Depart., Kingston, NY 12401 | 2020-03-31 |
| 1306474879 | Health Quest Medical Practice, PC | Surgery | 1240 Ulster Avenue --surg. Onc. Dept, Kingston, NY 12401 | 2020-03-31 |
| 1811523384 | Health Quest Medcial Practice, PC | Podiatrist | The Center for Wound Healing, 670 Stoneleigh Avenue, Carmel, NY 12401 | 2020-03-17 |
| 1013552181 | Health Quest Medical Practice, PC | Emergency Medicine | 1240 Ulster Avenue, Kingston, NY 12401 | 2019-11-13 |
| 1073156808 | Vala Conklin | Hearing Instrument Specialist | Beltone, 10 Westbrook Lane, Kingston, NY 12401 | 2019-10-24 |
| 1306304860 | Laura Juliane Isele | Dietitian, Registered | 521 Boices Lane Taconic Ddso, Kingston, NY 12401 | 2019-03-04 |
| 1104345107 | Shiv Ramlochan | Licensed Practical Nurse | 1 Family Drive, Kingston, NY 12401 | 2017-09-12 |
| 1346776333 | Sara Bockelmann | Licensed Practical Nurse | 616 Kiersted Ave, Kingston, NY 12401 | 2017-05-11 |
| 1093265472 | Janelle Haylett | Pathology | 121 Rondout Drive, Q, Kingston, NY 12401 | 2016-10-10 |
| 1669830873 | Julie Brady | Counselor | 154 Fair Street #2, Kingston, NY 12401 | 2016-02-02 |
| Find all providers in zip 12401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225637309 | Christine Marie Pabst | Nurse Practitioner | 667 Meadowland Ave, Kingston, PA 18704-5316 | 2020-10-20 |
| 1972126027 | Victoria Finn | Nurse Practitioner | 110 Summer St, Kingston, MA 02364-1419 | 2020-05-23 |
| 1104453158 | Nicola Richards | Nurse Practitioner | 80 Grand St, Kingston, NY 12401-3908 | 2020-03-26 |
| 1700369006 | Mary Christina Carter | Nurse Practitioner | 1215 River Bend Dr, Kingston, TN 37763-4528 | 2018-09-12 |
| 1568955342 | Debra L Mclaughlin | Nurse Practitioner | 2 Red Gate Dr, Kingston, NH 03848-3146 | 2018-06-07 |
| 1780107698 | Kelly Burger | Nurse Practitioner | 40 Hurley Ave Ste 4, Kingston, NY 12401-3738 | 2017-07-23 |
| 1720526437 | Tammy Lynn Williams | Nurse Practitioner | 7 N Main, Kingston, OK 73439 | 2017-02-02 |
| 1053774794 | Tressa Antionette Matchen | Nurse Practitioner | 701 East Hwy 70 Alliance Health Medical Group, Kingston, OK 73439 | 2016-03-31 |
| 1447693114 | Catherine Mary Harding | Nurse Practitioner | 141 South Maple Ave, Kingston, PA 18704 | 2013-04-12 |
| 1346589801 | John W Rosencrans Crnp, PC | Nurse Practitioner | 395 Osceola Ave, Kingston, PA 18704-5118 | 2013-02-04 |
| Find all providers in KINGSTON | ||||
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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.