DR. TIMOTHY DAVID GORDON (NPI# 1083920474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083920474 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY DAVID GORDON |
| Credential | PHD |
| Practice Address |
4102 Ben Franklin Blvd Durham NC 27704-2140 |
| Mailing Address |
Po Box 1630 Pinehurst NC 28370-1630 |
| Practice Telephone | 9199727700 |
| Practice Fax Number | 8772568588 |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2015-06-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 2011014431 | MO | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
4784 | NC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053324988 | Timothy Eugene Gordon | Optometrist | 5701 Herrera Dr, Santa Fe, NM 87507-2677 | 2006-08-14 |
| 1699247833 | Timothy Gordon | Nurse's Aide | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2018-12-28 |
| 1447669130 | Timothy Gordon | Pharmacist | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2014-08-06 |
| 1548338163 | Timothy R Gordon | Clinic/Center | 760 Hospital Circle, Browning, MT 59417-0760 | 2006-12-01 |
| 1750320453 | Timothy E Gordon | Ophthalmology | 1050 N James Campbell Blvd Ste 100, Columbia, TN 38401-2754 | 2006-06-06 |
| Street Address |
4102 BEN FRANKLIN BLVD |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-2140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871602532 | Valerie Frances Holmes | Psychiatry & Neurology | 4102 Ben Franklin Blvd, Durham, NC 27704-2140 | 2006-08-29 |
| 1073137030 | Elizabeth R Ward | Nurse Practitioner | 4102 Ben Franklin Blvd, Durham, NC 27704-2140 | 2020-06-04 |
| 1104396456 | Maimouna Diop | Nurse Practitioner | 4102 Ben Franklin Blvd, Durham, NC 27704-2140 | 2018-11-29 |
| 1528554219 | Stoney Lee Bowman | Nurse Practitioner | 4102 Ben Franklin Blvd, Durham, NC 27704-2140 | 2018-07-05 |
| 1255629820 | Carolina Behavorial Care Pa | Pharmacy | 4102 Ben Franklin Blvd, Durham, NC 27704-2140 | 2011-07-18 |
| 1952606329 | Susan B Vebber | Nurse Practitioner | 4102 Ben Franklin Blvd, Durham, NC 27704-2140 | 2011-01-17 |
| 1497081178 | Jason Southworth | Pharmacist | 4102 Ben Franklin Blvd, Durham, NC 27704 | 2009-10-30 |
| 1730234477 | Bryan D Smith | Psychiatry & Neurology | 4102 Ben Franklin Blvd, Durham, NC 27704-2140 | 2007-01-24 |
| 1356443659 | Gregory Alphonzia Simpson | Nurse Practitioner | 4102 Ben Franklin Blvd, Durham, NC 27704-2140 | 2006-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
| Find all providers in zip 27704 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708062 | Daniel Vanhoy Blalock | Psychologist | 411 W Chapel Hill St Ste 600, Durham, NC 27701-3270 | 2020-10-20 |
| 1265048342 | Joseph Giles Winger | Psychologist | 2200 W Main St Erwin Square Plaza, Durham, NC 27710-0001 | 2020-09-23 |
| 1124640537 | Katherine Ramos | Psychologist | 2200 W Main St Ste 300, Durham, NC 27705-4677 | 2020-05-08 |
| 1902436496 | Caitlin Marie Fang | Psychologist | 1200 Broad St Ste 103, Durham, NC 27705-3576 | 2020-01-23 |
| 1194376095 | Craig Daniel Libman | Psychologist | 508 Fulton St Dept 116b, Durham, NC 27705-3875 | 2019-09-23 |
| 1790346617 | Timothy Joseph Strauman | Psychologist | 708 Ivy Meadow Ln, Durham, NC 27707-6183 | 2019-06-21 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1881150795 | Courtney Dutton Cox | Psychologist | 508 Fulton St # 116c, Durham, NC 27705-3875 | 2019-02-15 |
| 1295290104 | Sarah E. Frost | Psychologist | 18 W Colony Pl Ste 280, Durham, NC 27705-5582 | 2019-02-05 |
| 1134639362 | Mark Edward Wolever | Psychologist | 1502 Nc Hwy 54 Wesst, Suite 406, Durham, NC 27707 | 2017-10-02 |
| Find all providers in DURHAM | ||||
Please comment or provide details below to improve the information on DR. TIMOTHY DAVID 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.