DR. KENNETH BRYCE GORDON (NPI# 1497752208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497752208 |
| Entity Type | Individual |
| Full Name | DR. KENNETH BRYCE GORDON |
| Credential | OD |
| Practice Address |
4811 S Laburnum Ave Richmond VA 23231-2713 |
| Practice Telephone | 8042261144 |
| Practice Fax Number | 8042369026 |
| Mailing Telephone | 8042261144 |
| Mailing Fax Number | 8042369026 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2013-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 0618000495 | VA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 9232362 | 05 | |
| VA | RAILROAD MEDICARE TAX ID | 541783118 | 01 |
| VA | RAILROAD MEDICARE UPIN | U84594 | 01 |
| VA | RAILROAD PROVIDER | P00068065 | 01 |
| VA | RAILROAD MEDICARE PIN | DA5536 | 01 |
| MEDICARE TAX ID | 541783118 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225529043 | Kenneth Steven Gordon | Psychologist | 755 Lakefield Rd Ste J, Westlake Village, CA 91361-2639 | 2018-05-29 |
| 1154796456 | Kenneth Gordon | Pharmacist | 5261 Nw 81st Ter, Lauderhill, FL 33351-5050 | 2015-12-11 |
| 1548301021 | Kenneth Lawrence Gordon | Psychiatry & Neurology | 75 Chestnut St., Oneonta, NY 13820 | 2007-02-09 |
| 1790865806 | Kenneth B. Gordon | Dermatology | 9200 W Wisconsin Ave, Department of Dermatology, Milwaukee, WI 53226-3522 | 2006-10-16 |
| 1104837657 | Kenneth L. Gordon | Ophthalmology | 2080 Century Park East, #800, Los Angeles, CA 90067-2011 | 2006-08-10 |
| 1871549204 | Kenneth D Gordon | Internal Medicine | 1602 Vernon Rd, Suite 400, Lagrange, GA 30240-4100 | 2006-05-26 |
| Street Address |
4811 S LABURNUM AVE |
| City | RICHMOND |
| State | VA |
| Zip Code | 23231-2713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184788457 | Dr Clifford Roffis and Associates Odpc | Optometrist | 4811 S Laburnum Ave, Richmond, VA 23231-2713 | 2006-12-21 |
| 1114991460 | Clifford Alan Roffis | Optometrist | 4811 S Laburnum Ave, Richmond, VA 23231-2713 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114524766 | Latoya Steward | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 805 Admiral Gravely Blvd, Richmond, VA 23231 | 2020-10-07 |
| 1548721160 | Ray E Hill Jr. | Non-emergency Medical Transport (VAN) | 9469 Barrett Pl, Richmond, VA 23231 | 2019-03-27 |
| 1265922314 | Bon Secours - Richmond Community Hospital, Incorporated | Pediatrics | 4744 Finlay St, Richmond, VA 23231 | 2018-05-15 |
| 1225371743 | Vantage Point Community Supports, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8005 Diamond Ridge Court, Henrico, VA 23231 | 2013-04-03 |
| 1255586277 | Bon Secours - Richmond Community Hospital, Incorporated | Clinic/Center | 4630 S. Laburnum Ave., Suite C, Richmond, VA 23231 | 2008-11-18 |
| 1407050982 | Tawana Toneke Olds-davis | Counselor | 4305 Hillbrook Ave, Richmond, VA 23231 | 2007-06-11 |
| 1891814844 | East End Pediatrics, P.C. | Pediatrics | 4744 Finlay Street, Richmond, VA 23231 | 2007-03-29 |
| 1235229113 | Aunt Anns Home for Adolescents | Counselor | 5901 Almond Creek N Lane, Richmond, VA 23231 | 2006-10-13 |
| 1962500421 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5100 South Laburnum Ave Laburnum Sq, Richmond, VA 23231 | 2006-09-20 |
| 1043243546 | Bon Secours-virginia Healthsource | Family Medicine | 4835 S Laburnum Ave, Richmond, VA 23231 | 2006-07-08 |
| Find all providers in zip 23231 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942819370 | Chelsey Hoang | Optometrist | 5439 Atwood Canyon Ct, Richmond, TX 77407-2986 | 2020-07-31 |
| 1629627559 | Seth Gorman | Optometrist | 4501 S Laburnum Ave Ste 145, Richmond, VA 23231-2483 | 2019-09-04 |
| 1730732728 | Tso Richmond Aliana Pa | Optometrist | 10117 W. Grand Parkway South, Suite 101, Richmond, TX 77407 | 2019-07-19 |
| 1811549751 | Christopher Tran | Optometrist | 7101 W Grand Pkwy S Ste 170b, Richmond, TX 77407-8656 | 2019-07-11 |
| 1659933943 | Daniel Max & Marcandrea LLC | Optometrist | 22377 Bellaire Blvd Ste 300, Richmond, TX 77407-3926 | 2019-07-08 |
| 1639633753 | Grand Eye Care, LLC | Optometrist | 4828 Waterview Town Center, Suite 300, Richmond, TX 77406 | 2019-01-23 |
| 1346711132 | Texas Eyecare & Optical LLC | Optometrist | 8710 Grand Mission Blvd Ste D, Richmond, TX 77407-5413 | 2018-12-06 |
| 1831671213 | Jamie Pucci | Optometrist | 8700 Stony Point Pkwy Ste 240, Richmond, VA 23235-1966 | 2018-09-03 |
| 1285115758 | Cz Eye Care, Pllc | Optometrist | 18310 West Airport, Suite 900, Richmond, TX 77407 | 2018-08-23 |
| 1124516927 | Hoang Squared | Optometrist | 11020 Harlem Rd Ste 800, Richmond, TX 77406 | 2018-04-26 |
| Find all providers in RICHMOND | ||||
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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.