BRETT ADAM GORDON (NPI# 1801819610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801819610 |
| Entity Type | Individual |
| Full Name | BRETT ADAM GORDON |
| Credential | PA-C |
| Practice Address |
3001 Edwards Mill Rd # 200 Raleigh NC 27612-5243 |
| Practice Telephone | 9197815600 |
| Practice Fax Number | 9198636821 |
| Mailing Telephone | 9197815600 |
| Mailing Fax Number | 9198636821 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2015-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
104178 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538454491 | Brett Michael Gordon | Pharmacist | 7300 191st St, Tinley Park, IL 60487-9361 | 2011-06-17 |
| Street Address |
3001 EDWARDS MILL RD # 200 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27612-5243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265418123 | Laura A. Beaver | Occupational Therapist | 3001 Edwards Mill Rd # 200, Raleigh, NC 27612-5243 | 2005-12-21 |
| 1316554355 | Zachary Small | Physical Therapy Assistant | 3001 Edwards Mill Rd # 200, Raleigh, NC 27612-5243 | 2020-09-24 |
| 1447804455 | Nicole Acree | Physical Therapy Assistant | 3001 Edwards Mill Rd # 200, Raleigh, NC 27612-5243 | 2019-07-29 |
| 1386122885 | Gracy Sheely | Physical Therapist | 3001 Edwards Mill Rd # 200, Raleigh, NC 27612 | 2018-08-06 |
| 1265884886 | Tawnee Cain | Occupational Therapist | 3001 Edwards Mill Rd # 200, Raleigh, NC 27612-5243 | 2016-07-07 |
| 1235596727 | Peggy Molyneux | Physician Assistant | 3001 Edwards Mill Rd # 200, Raleigh, NC 27612-5243 | 2016-01-28 |
| 1164801429 | Jeremy Bales | Physical Therapist | 3001 Edwards Mill Rd # 200, Raleigh, NC 27612 | 2015-05-20 |
| 1972924645 | Amy Poole | Physical Therapist | 3001 Edwards Mill Rd # 200, Raleigh, NC 27612-5243 | 2013-12-26 |
| 1588098222 | Ashley Anne Schaus | Physical Therapist | 3001 Edwards Mill Rd # 200, Raleigh, NC 27612-5243 | 2013-08-29 |
| 1508135427 | Brianna M Eby | Physical Therapist | 3001 Edwards Mill Rd # 200, Raleigh, NC 27612 | 2011-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538714068 | George J Henderon | Orthotist | 5313 Duraleigh Road, Ste 151, Raleigh, NC 27612 | 2019-08-01 |
| 1902399223 | Iain Knox Nathaniel Irwin | Marriage & Family Therapist | 7701 Alborz Dr, Raleigh, NC 27612 | 2018-06-12 |
| 1225525884 | Patterns Behavioral Services North Carolina, Inc | Assistant Behavior Analyst | 3738 National Dr, Ste 110, Raleigh, NC 27612 | 2018-04-19 |
| 1053820720 | The Art Counseling L.L.C. | Psychologist | 4610 Twisted Oaks Drive Apt 1807, Raleigh, NC 27612 | 2017-09-26 |
| 1376052431 | Amanda Steed | Speech-Language Pathologist | 5519 Hamstead Crossing, Raleigh, NC 27612 | 2017-09-21 |
| 1295250991 | Neal H. Patel Dds Pllc | Dentist | 7211 Shellburne Dr, Raleigh, NC 27612 | 2017-08-03 |
| 1811426109 | Marquita Randolph-breeden | Behavior Technician | 5816 Creedmoor Road, Suite 104, Raleigh, NC 27612 | 2017-06-08 |
| 1336518554 | Travis Edward Williams | Counselor | 4801 Glenwood Ave., Suite 200, Raleigh, NC 27612 | 2015-09-17 |
| 1831587476 | Harris Teeter LLC | Pharmacy | 2051 W Millbrook Road, Raleigh, NC 27612 | 2015-01-06 |
| 1780072975 | Harris Teeter LLC | Pharmacy | 2051 W. Millbrook Road, Raleigh, NC 27612 | 2014-12-23 |
| Find all providers in zip 27612 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407170079 | Stephanie Solosko | Physician Assistant | 8238 Primanti Blvd, Raleigh, NC 27612-7413 | 2010-03-25 |
| 1386817203 | Katherine Noland Sherron | Physician Assistant | 10941 Raven Ridge Rd Ste 103, Raleigh, NC 27614-6487 | 2008-04-11 |
| 1053430652 | Sharon Ann Mowrey | Physician Assistant | 3333 Clandon Park Dr, Raleigh, NC 27613-8841 | 2007-03-28 |
| 1306907043 | Roshni Patel Mapp | Physician Assistant | Duke Thoracic Surgery of Raleigh, 3404 Wake Forest Rd, Suite 201, Raleigh, NC 27609 | 2006-12-13 |
| 1437186152 | Rita Marie Langworth-brewer | Physician Assistant | 3737 Glenwood Ave, Raleigh, NC 27612-5515 | 2006-06-27 |
| 1033716634 | Sarah Petty Butler | Physician Assistant | 5838 Six Forks Rd Ste 100, Raleigh, NC 27609-3893 | 2020-10-06 |
| 1043829534 | Samantha Talbot Brown | Physician Assistant | 4509 Creedmoor Rd Ste 201, Raleigh, NC 27612-3813 | 2020-07-30 |
| 1093361859 | Kirsten Sinclair Renz | Physician Assistant | 3320 Wake Forest Rd Ste 450, Raleigh, NC 27609-7300 | 2019-08-16 |
| 1265087076 | Lauren Wells Queen | Physician Assistant | 11200 Governor Manly Way Ste 309, Raleigh, NC 27614-7375 | 2019-08-08 |
| 1730734211 | Shea Tryon Whittaker | Physician Assistant | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-08-02 |
| Find all providers in RALEIGH | ||||
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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.