CHARLES GORDON (NPI# 1134642655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134642655 |
| Entity Type | Individual |
| Full Name | CHARLES GORDON |
| Practice Address |
3701 12th St N Ste 202 Saint Cloud MN 56303-2253 |
| Practice Telephone | (320) 258-3090 |
| Mailing Telephone | 3202583090 |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | R2255361 | MN | 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 |
| 1114382025 | Charles Gordon Jr. | Physician Assistant | 315 S Manning Blvd, Albany, NY 12208-1707 | 2015-12-18 |
| 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 |
3701 12TH ST N STE 202 |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-2253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972695302 | Mary C Macleod | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303 | 2006-09-30 |
| 1881237840 | Laura Anne Karnik | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2019-10-22 |
| 1083256135 | Amanda Lynn Braun | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2019-10-10 |
| 1700442282 | Cassandra Cae Clark | Registered Nurse | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2019-05-10 |
| 1205392743 | Nathan Wenker | Registered Nurse | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2019-02-19 |
| 1447724406 | James Richard Tarcon | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2019-01-14 |
| 1780156935 | Kendell Elizabeth Crawford | Registered Nurse | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2018-12-28 |
| 1427548031 | Kirk V. Denti | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2018-05-18 |
| 1184124265 | Kelly Ann Thompson | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2018-02-15 |
| 1942717046 | Bailey Dykema | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2018-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598183923 | Northland Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 2055 15th St N Ste B, Saint Cloud, MN 56303-1543 | 2014-04-02 |
| 1801226923 | Scott Bertram | Nurse Anesthetist, Certified Registered | 1769 Poppy Rd, Saint Cloud, MN 56303-0634 | 2013-11-26 |
| 1477985505 | Barbara Jean Quick | Nurse Anesthetist, Certified Registered | 6358 Oak Shore Dr, Saint Cloud, FL 34771-8641 | 2013-07-31 |
| 1114232766 | Gregory S. Erickson | Nurse Anesthetist, Certified Registered | 1117 7th St N Apt 11, Saint Cloud, MN 56303-3419 | 2010-08-06 |
| 1972695302 | Mary C Macleod | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303 | 2006-09-30 |
| 1033173695 | Penny Renee Janorschke | Nurse Anesthetist, Certified Registered | 1406 6th St N, Saint Cloud, MN 56303-3305 | 2006-04-12 |
| 1558985747 | Bobbi Jo Majerus | Nurse Anesthetist, Certified Registered | 1526 Northway Dr, Saint Cloud, MN 56303-1255 | 2020-06-03 |
| 1881237840 | Laura Anne Karnik | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2019-10-22 |
| 1184267445 | Vera Gesare Lwanga-zaman | Nurse Anesthetist, Certified Registered | 1406 6th Ave N, Saint Cloud, MN 56303-1901 | 2019-10-18 |
| 1083256135 | Amanda Lynn Braun | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2019-10-10 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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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.