SAMUEL ANTONIO GORDON (NPI# 1689684888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689684888 |
| Entity Type | Individual |
| Full Name | SAMUEL ANTONIO GORDON |
| Credential | PH.D. |
| Practice Address |
102 Irving St Nw Washington DC 20010-2921 |
| Practice Telephone | 2028771000 |
| Practice Fax Number | 2022915366 |
| Mailing Telephone | 2028771000 |
| Mailing Fax Number | 2022915366 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-12-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY 1528 | DC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KAISER | 103645 | 01 | |
| AETNA HMO | SMD 3839272 | 01 | |
| AETNA NON HMO | 5681292 | 01 | |
| MAMSI | 247626 | 01 | |
| BS NCA | H360-0004 | 01 | |
| NCPPO | 512762 | 01 | |
| AETNA HMO | DC 2528584 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912001470 | Samuel A. S. Gordon | Obstetrics & Gynecology | 8177 Glades Road, Bay 25, Boca Raton, FL 33434 | 2006-09-12 |
| 1194838854 | Samuel Jay Gordon | Dentist | 37 Gill Ln, Iselin, NJ 08830-2800 | 2006-08-16 |
| 1033642848 | Samuel S Gordon | Student in an Organized Health Care Education/Training Program | 757 Westwood Plz Ste 7501, Los Angeles, CA 90095-8358 | 2017-04-07 |
| 1508160334 | Samuel Lance Gordon | Chiropractor | 4101 Us Highway 77, M-5, Corpus Christi, TX 78410-4542 | 2011-01-09 |
| Street Address |
102 IRVING ST NW |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20010-2921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265435291 | Howard Anthony Gilmer | Physical Medicine & Rehabilitation | 102 Irving St Nw, Washington, DC 20010-2921 | 2005-05-23 |
| 1902419757 | Chinyere Ukaegbu | Student in an Organized Health Care Education/Training Program | 102 Irving St Nw, Washington, DC 20010-2921 | 2020-08-30 |
| 1053923888 | Theresa Buechler | Student in an Organized Health Care Education/Training Program | 102 Irving St Nw, Washington, DC 20010-2921 | 2020-08-22 |
| 1649881806 | Ramiro Escalera | Student in an Organized Health Care Education/Training Program | 102 Irving St Nw, Washington, DC 20010-2921 | 2020-08-12 |
| 1891317459 | Maya Paz | Occupational Therapist | 102 Irving St Nw, Washington, DC 20010-2921 | 2020-05-17 |
| 1790307981 | Holly Jane Wilde Calhoun | Speech-Language Pathologist | 102 Irving St Nw, Washington, DC 20010-2921 | 2020-05-11 |
| 1023646817 | Amit Sharma | Student in an Organized Health Care Education/Training Program | 102 Irving St Nw, Washington, DC 20010-2921 | 2020-03-29 |
| 1639707474 | Sargoon Nepaul | Student in an Organized Health Care Education/Training Program | 102 Irving St Nw, Washington, DC 20010-2921 | 2020-03-28 |
| 1366076218 | Hannah Smith | Physical Therapist | 102 Irving St Nw, Washington, DC 20010-2921 | 2020-03-01 |
| 1740812817 | Karen Gragnani | Occupational Therapist | 102 Irving St Nw, Washington, DC 20010-2921 | 2020-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134728397 | Blueiris LLC | Clinic/Center | 3318 Georgia Ave Nw, Unit 13, Washington, DC 20010 | 2020-10-20 |
| 1700425618 | Eve Kronzek | Audiologist | Children's National Hospital, 111 Michigan Ave Nw, Suite 1250, Washington, Dc, DC 20010 | 2019-12-26 |
| 1366085169 | Jakeline Xochitl Merino | Nurse Practitioner | 106 Irving At Nw, Suite 419, Washington Dc, DC 20010 | 2019-10-24 |
| 1710548110 | Ebrahim Hasan Khan | Student in an Organized Health Care Education/Training Program | 110 Irving St Nw Dept of Int Med, Washington, DC 20010 | 2019-06-26 |
| 1932660362 | Matthew Joseph Moon | Physician Assistant | Medstar Washington Hospital Center - Sicu, 110 Irving Street Nw, Washington, DC 20010 | 2019-03-28 |
| 1316407463 | Rabia Idrees | Student in an Organized Health Care Education/Training Program | 110 Irving St. Nw Dept of Internal Medicine, Washington, DC 20010 | 2019-03-24 |
| 1588124168 | Nishita Patel | Student in an Organized Health Care Education/Training Program | 110 Irving St. Nw Dept of Obstetrics and Gynecology, Washington, DC 20010 | 2019-03-21 |
| 1861958035 | Melissa Ann Williams | Home Health Aide | 3506 Georgia Ave Nw #102, Washington, DC 20010 | 2019-02-13 |
| 1073080602 | Jingzhe Gao | Registered Nurse | Medstar National Rehabilitation Network, 102 Irving Street, Nw, Washington, DC 20010 | 2018-11-01 |
| 1487140737 | Anees Musallam Sr. | Student in an Organized Health Care Education/Training Program | 110 Irving St. Nw Dept of Interventional Cardiology, Washington, DC 20010 | 2018-07-09 |
| Find all providers in zip 20010 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900110 | Betsy Mencher, Ph.d. Pllc | Psychologist | 1350 Connecticut Ave Nw Ste 500, Washington, DC 20036-1736 | 2020-10-20 |
| 1083211130 | Malcolm Horace Woodland | Psychologist | 1815 N Capitol St Ne, Washington, DC 20002-1535 | 2020-10-01 |
| 1902416217 | Eric Todd Jones | Psychologist | 3220 15th St Ne, Washington, DC 20017-2936 | 2020-08-03 |
| 1811507148 | Michael Magenheimer | Psychologist | 4430 13th Pl Ne, Washington, DC 20017-2729 | 2020-08-02 |
| 1942827407 | Courtney Dinsmore | Psychologist | 6621 31st St Nw, Washington, DC 20015-2345 | 2020-07-01 |
| 1386265098 | John Loughlin-presnal | Psychologist | 37th and O Streets Nw One Darnall Hall, Washington, DC 20057-0001 | 2020-05-04 |
| 1457972242 | Holly Anne Weber | Psychologist | 4001 Harewood Rd Ne Rm 110, Washington, DC 20017-1508 | 2020-05-03 |
| 1609406248 | The Ludic Group | Psychologist | 1350 Connecticut Ave Nw Ste 307, Washington, DC 20036-1738 | 2020-01-23 |
| 1164060596 | Brigit Monica Van Widenfelt | Psychologist | 5208 41st St Nw, Washington, DC 20015-1902 | 2019-12-16 |
| 1205477700 | Kingston Psychological Services | Psychologist | 10 G St Ne Ste 600, Washington, DC 20002-4253 | 2019-10-05 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20010 |
Please comment or provide details below to improve the information on SAMUEL ANTONIO GORDON.
| 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.