MR. CHARLES GORDON JR. (NPI# 1114382025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114382025 |
| Entity Type | Individual |
| Full Name | MR. CHARLES GORDON JR. |
| Credential | PA-C |
| Practice Address |
315 S Manning Blvd Albany NY 12208-1707 |
| Mailing Address |
Po Box 14890 Albany NY 12212-4890 |
| Practice Telephone | 5182521550 |
| Mailing Telephone | 5185255634 |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2018-04-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 019257 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942692769 | Charles Gordon | Physical Therapist | 29 Center St Ste 1, Goffstown, NH 03045-2948 | 2015-03-03 |
| 1811019268 | Charles Thomas Gordon IIi | Psychiatry & Neurology | 11204 Farmland Dr, Rockville, MD 20852-4522 | 2007-04-05 |
| 1821103631 | Charles Albert Gordon | Physical Medicine & Rehabilitation | 1059 S Fairfax Ave, Los Angeles, CA 90019-4402 | 2006-08-20 |
| 1831164722 | Charles G. Gordon | Dentist | 1026 Eagleridge Blvd, Pueblo, CO 81008-2130 | 2006-02-22 |
| 1649243890 | Charles F Gordon | Anesthesiology | 9 Old Plank Rd Ste 100, Clifton Park, NY 12065-3107 | 2006-02-08 |
| 1326049529 | Charles Richard Gordon | Family Medicine | 200 Cabrini Blvd, Suite 17, New York, NY 10033-1100 | 2005-08-10 |
| 1750858700 | Charles Gordon | Case Manager/Care Coordinator | 4269 Pearl Rd, Cleveland, OH 44109-4234 | 2018-10-29 |
| 1134642655 | Charles Gordon | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2017-07-18 |
| 1275825135 | Charles Marvin Gordon Jr. | Orthopaedic Surgery | 1505 Daphne Ave, Daphne, AL 36526 | 2011-05-11 |
| 1841405743 | Charles Robert Gordon | Specialist/Technologist | 3910 Teays Valley Rd, Hurricane, WV 25526-9756 | 2007-05-14 |
| Street Address |
315 S MANNING BLVD |
| City | ALBANY |
| State | NY |
| Zip Code | 12208-1707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750382131 | Lisle A Eaton Jr. | Pathology | 315 S Manning Blvd, Sph Maplewood Pathology, Albany, NY 12208-1707 | 2005-08-09 |
| 1962002071 | Stephen M Chamberlin | Pharmacist | 315 S Manning Blvd, Albany, NY 12208-1789 | 2020-10-28 |
| 1528675576 | Rebecca Sanders | Social Worker | 315 S Manning Blvd, Albany, NY 12208-1707 | 2020-09-24 |
| 1801406830 | Nicola Katherine Rizzo | Nurse Practitioner | 315 S Manning Blvd, Albany, NY 12208-1707 | 2020-08-04 |
| 1972111854 | Amy Vanamburgh | Nurse Practitioner | 315 S Manning Blvd, Albany, NY 12208-1707 | 2020-07-16 |
| 1518582089 | Aktham Jay Adams | Student in an Organized Health Care Education/Training Program | 315 S Manning Blvd, Albany, NY 12208-1707 | 2020-06-10 |
| 1720602493 | Capital District Pathology Associates Pllc | Pathology | 315 S Manning Blvd, Albany, NY 12208-1707 | 2020-05-29 |
| 1194346718 | Brittany Nora Center | Registered Nurse | 315 S Manning Blvd, Albany, NY 12208-1789 | 2020-05-05 |
| 1790306579 | Katherine Rose Hiles | Nurse Practitioner | 315 S Manning Blvd, Albany, NY 12208-1707 | 2020-05-03 |
| 1972134005 | Sarah Beth Eldredge | Physical Therapist | 315 S Manning Blvd, Albany, NY 12208-1707 | 2020-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959045 | Fatima Mahmood | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Department of Internal Medicine, Albany, NY 12208 | 2020-07-08 |
| 1861021784 | Jessica Anne Charles-larose | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Family Medicine, Albany, NY 12208 | 2020-04-02 |
| 1235767211 | Michael Charles Harrington | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Orthopedic Surgery, Albany, NY 12208 | 2020-03-27 |
| 1518594126 | Arkar Htoo | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Pathology, Albany, NY 12208 | 2020-03-24 |
| 1366079030 | Omar Merdan | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Dept of Medicine/pediatrics, Albany, NY 12208 | 2020-03-24 |
| 1306473079 | Sergo Gabunia | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of General Surgery, Albany, NY 12208 | 2020-03-24 |
| 1205469392 | Cornell Andre Morris | Social Worker | Albany Stratton Va Medical Center, 113 Holland Avenue, Albany, NY 12208 | 2020-02-17 |
| 1558909234 | St. Peter's Health Partners Medical Associates, P.C. | Surgery | 319 South Manning Blvd Suite 310, Capital Region Colon & Rectal Surgery, Albany, NY 12208 | 2019-12-13 |
| 1912543265 | Meghan Rose Baxter | Social Worker | 58 Academy Rd., Albany, NY 12208 | 2019-11-21 |
| 1245883461 | Gwendolyn Medak | Registered Nurse | 15 New Scotland Ave, Albany, NY 12208 | 2019-07-17 |
| Find all providers in zip 12208 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619129 | Anna Leigh Vonck | Physician Assistant | 2 Executive Park Dr Ste 2, Albany, NY 12203-3700 | 2020-11-04 |
| 1407409113 | Morgan Shumway | Physician Assistant | 50 New Scotland Ave # Mc191, Albany, NY 12208-3403 | 2019-07-22 |
| 1588136279 | Christine Ciavarella | Physician Assistant | 405 Kains Ave Ste 205, Albany, CA 94706-1270 | 2018-12-19 |
| 1225503535 | Maura Kathleen Corbett | Physician Assistant | 43 New Scotland Ave Mc-139, Department of Emergency Medicine, Albany, NY 12208-3478 | 2018-10-12 |
| 1669966743 | Kimberly Aebli | Physician Assistant | 47 New Scotland Ave Mc 101, Albany, NY 12208 | 2018-06-21 |
| 1255844643 | Erica Francesca Lari Parks | Physician Assistant | 530 Kinkead Way Apt 205, Albany, CA 94706-2656 | 2017-11-08 |
| 1306376934 | Elisabeth Catherine Henderson | Physician Assistant | 98 Wolf Rd Ste 16, Albany, NY 12205-1226 | 2017-06-15 |
| 1417306374 | Larry James Edwards | Physician Assistant | 2030 Newton Rd, Albany, GA 31701-3520 | 2016-06-10 |
| 1477923019 | Cheyenne Allen Boone | Physician Assistant | 47 New Scotland Ave Mc-139, Albany Medical Center Dept Emergency Medicine, Albany, NY 12208-3412 | 2015-09-25 |
| 1396148300 | Tina Huang | Physician Assistant | 15 Norman Ave, Albany, NY 12203-5005 | 2014-10-03 |
| Find all providers in ALBANY | ||||
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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.