MR. KEVIN BRUCE GORDON (NPI# 1134776479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134776479 |
| Entity Type | Individual |
| Full Name | MR. KEVIN BRUCE GORDON |
| Practice Address |
1816 Sydenham Trail Virginia Beach VA 23464-8917 |
| Mailing Address |
1816 Sydenham Trl Virginia Beach VA 23464-8917 |
| Practice Telephone | 7576350578 |
| Mailing Telephone | 7576350578 |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 0202009072 | VA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649787367 | Kevin B Gordon | Specialist/Technologist | 3618 Madaca Ln, Tampa, FL 33618-2057 | 2018-01-03 |
| 1902277528 | Kevin Gordon | Registered Nurse | 9500 Euclid Ave., Cleveland, OH 44106 | 2015-10-08 |
| 1053723643 | Kevin Gordon | Contractor | 12222 E 30th St, Tulsa, OK 74129-8423 | 2014-05-29 |
| 1174815625 | Kevin C Gordon | Internal Medicine | 1011 Reed Ave, Suite 300, Wyomissing, PA 19610-2002 | 2011-05-03 |
| 1811082431 | Kevin Gordon | Family Medicine | 152 W Lincoln Hwy, Chicago Heights, IL 60411-2619 | 2006-10-03 |
| 1740383736 | Kevin Gordon | Specialist | 875 Poplar Church Rd, Suite 320, Camp Hill, PA 17011-2203 | 2006-09-06 |
| 1437151370 | Kevin J Gordon | Internal Medicine | 1610 W University Blvd, Durant, OK 74701-3045 | 2005-08-11 |
| 1871597666 | Kevin R Gordon | Obstetrics & Gynecology | 505 Omega Dr, Arlington, TX 76014-2004 | 2005-06-09 |
| Street Address |
1816 SYDENHAM TRAIL |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23464-8917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610581 | Ainsley's Angels of America | Durable Medical Equipment & Medical Supplies | 828 Cabrini Place, Virginia Beach, VA 23464 | 2019-03-29 |
| 1104313055 | Your Family Is Family Home Healthcare Services, LLC | Respite Care | 1311 Hafford Road, Virginia Beach, VA 23464 | 2018-04-17 |
| 1497274765 | Jamie Crisman | Occupational Therapist | 1400 Fordham Drive, Virginia Beach, VA 23464 | 2017-09-18 |
| 1861919334 | Joshua Hoxter | Chiropractor | 6070 Indian River Rd Ste 102, Virginia Beach, VA 23464 | 2017-08-25 |
| 1669909917 | Toni Faye Tayag | Specialist/Technologist | 909 Tidemark Court, Virginia Beach, VA 23464 | 2017-05-17 |
| 1922545540 | Divinefavor LLC | Non-emergency Medical Transport (VAN) | 1014 Level Green Blvd, Virginia Beach, VA 23464 | 2017-01-20 |
| 1326499807 | David Klucznik | Dentist | 5564 Indian River Road, Virginia Beach, VA 23464 | 2016-06-27 |
| 1093161374 | Mawussi Komi | General Acute Care Hospital | 6271 Drew Dr, Va Beach, VA 23464 | 2016-05-05 |
| 1588071807 | Linda Mathis | Skilled Nursing Facility | 5520 Indian Road, Virginia Beach, VA 23464 | 2014-07-18 |
| 1083045561 | Manny-nelson Med LLC | Durable Medical Equipment & Medical Supplies | 1612 Centerville Turnpike, Suite 308, Virginia Beach, VA 23464 | 2013-12-09 |
| Find all providers in zip 23464 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699373100 | Marie Burger Delmonte | Pharmacist | 4540 Princess Anne Rd Ste 117, Virginia Beach, VA 23462-7963 | 2020-10-16 |
| 1992303648 | Arryn Butler | Pharmacist | 2105 Princess Anne Rd Ste 100, Virginia Beach, VA 23456-4164 | 2020-10-14 |
| 1053940668 | Terrence Alan Greenquist | Pharmacist | 205 80th St, Virginia Beach, VA 23451-1930 | 2020-04-06 |
| 1538793377 | James Melvin Powers Jr. | Pharmacist | 3125 Swainsons Ln, Virginia Beach, VA 23456-3459 | 2020-03-02 |
| 1710534086 | Boyette Enterprises LLC | Pharmacist | 3852 Virginia Beach Blvd Unit B, Virginia Beach, VA 23452-2489 | 2019-08-21 |
| 1891275228 | Tommi Jean Robson | Pharmacist | 1013 Torngat Ct # Usa, Virginia Beach, VA 23454-6728 | 2018-08-15 |
| 1841705480 | Maria Achilleos | Pharmacist | 800 Independence Blvd Ste 100, Virginia Beach, VA 23455-6011 | 2017-12-05 |
| 1083130249 | Anne Hume | Pharmacist | 521 Laskin Rd, Virginia Beach, VA 23451-3901 | 2017-08-19 |
| 1295255891 | Donald Patrick Durkee | Pharmacist | 4776 Marlborough Dr, Virginia Beach, VA 23464-3037 | 2017-06-23 |
| 1255864351 | Zakirah N Pratt | Pharmacist | 1330 Amerigroup Way, Virginia Beach, VA 23464-5144 | 2017-04-05 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23464 |
Please comment or provide details below to improve the information on MR. KEVIN BRUCE 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.