CARMELINA GORDON (NPI# 1952399297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952399297 |
| Entity Type | Individual |
| Full Name | CARMELINA GORDON |
| Credential | M.D. |
| Practice Address |
850 W North St Ste 100 Jackson MI 49202-3196 |
| Mailing Address |
850 W North St Ste 104 Jackson MI 49202-3196 |
| Practice Telephone | 8778528463 |
| Practice Fax Number | 5178413034 |
| Mailing Telephone | (877) 852-8463 |
| Mailing Fax Number | 5178170144 |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2017-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 4301063145 | MI | Allopathic & Osteopathic Physicians |
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
4301063145 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 180044966 | 01 | |
| MI | BCBSM | 180C846310 | 01 |
| MI | BCBSM | 180H149970 | 01 |
| MI | 4380786 | 05 | |
| MI | 4496389 | 05 |
| Street Address |
850 W NORTH ST STE 100 |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-3196 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205824547 | Surendar S Purohit | Ophthalmology | 850 W North St Ste 100, Jackson, MI 49202-3196 | 2005-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225449317 | David Kilpatrick | Ophthalmology | 1200 N State St Ste 300, Jackson, MS 39202-2027 | 2014-05-12 |
| 1255974309 | Retina Institute of Mississippi | Ophthalmology | 971 Lakeland Dr Ste 657, Jackson, MS 39216-4608 | 2019-10-22 |
| 1962780023 | Brian C. Tieu | Ophthalmology | 2500 N State St, Jackson, MS 39216-4500 | 2011-07-22 |
| 1669760385 | Albert L. Lin | Ophthalmology | 2500 N State St, Jackson, MS 39216 | 2011-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639781545 | Harbor Retina Center Pllc | Ophthalmology | 3273 Davison Rd Ste 1, Lapeer, MI 48446-2902 | 2020-08-21 |
| 1902260698 | Drew Scoles | Ophthalmology | 3555 W 13 Mile Rd Ste Ll-20, Royal Oak, MI 48073-6710 | 2016-04-08 |
| 1225007198 | Steven A Boskovich Md PC | Ophthalmology | 1290 S Linden Rd, Flint, MI 48532-3407 | 2006-03-14 |
Please comment or provide details below to improve the information on CARMELINA 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.