MR. JOHN DAVID GORDON (NPI# 1831158351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831158351 |
| Entity Type | Individual |
| Full Name | MR. JOHN DAVID GORDON |
| Credential | PAC |
| Practice Address |
88 E Tioga Ave Ste 102 88 Tioga Avenue, Ste 102 Corning NY 14830-2858 |
| Mailing Address |
88 E Tioga Ave Ste 102 Smith Allergy & Asthma of Cny Pllc Corning NY 14830-2858 |
| Practice Telephone | 6076846115 |
| Practice Fax Number | 6076846120 |
| Mailing Telephone | 6076846115 |
| Mailing Fax Number | 6076846120 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2016-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 004758 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | MA051642 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | MEDICARE PTAN | J400278137 | 01 |
| PA | RR MEDICARE GROUP | CC9269 | 01 |
| PA | MEDICARE GROUP | GU040061 | 01 |
| PA | RR MEDICARE PIN | P00177089 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720566151 | John Gordon | Pharmacist | 18740 Se River Ridge Rd, Tequesta, FL 33469-8106 | 2018-07-28 |
| 1265672331 | John Huntington Gordon | Speech-Language Pathologist | 280 Warburton Ave, Hastings On Hudson, NY 10706-2809 | 2009-03-02 |
| 1952422560 | John Robert Gordon | Dentist | 5901 Nw 63rd Ter, Suite150, Kansas City, MO 64151-3319 | 2007-04-02 |
| 1093868051 | John Edward Gordon | Psychiatry & Neurology | 1200 W. Ironwood, Suite # 306, Coeur D' Alene, ID 83814 | 2007-01-20 |
| 1902985120 | John Joseph Gordon | Dentist | 2425 Sw Vermont St, Portland, OR 97219-1939 | 2006-11-06 |
| 1134205586 | John A Gordon Jr. | Dentist | 901 West Route 34, Suite 103, Plano, IL 60545 | 2006-10-28 |
| 1669557526 | John Charles Gordon | Orthopaedic Surgery | 6830 Hospital Drive #202, Baltimore, MD 21237-4377 | 2006-10-26 |
| 1801980479 | John Gordon | Obstetrics & Gynecology | 11126 Kingston Pike, Knoxville, TN 37934-2806 | 2006-10-03 |
| 1750491866 | John Lynn Gordon | Dentist | 1315 South 8th, Deming, NM 88030 | 2006-08-30 |
| 1538145180 | John G Gordon | Pharmacist | 115 N Granite Ave, Granite Falls, WA 98252-2348 | 2005-12-15 |
| Street Address |
88 E TIOGA AVE STE 102 88 TIOGA AVENUE, STE 102 |
| City | CORNING |
| State | NY |
| Zip Code | 14830-2858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285186320 | Jacqueline Czwojdak | Physician Assistant | 88 E Tioga Ave Ste 102, Corning, NY 14830-2882 | 2016-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295358836 | Shehla Javed | Registered Nurse | 3 Corning Dr, Corning, NY 14830 | 2020-05-18 |
| 1285993246 | Karen Adams | Physical Therapy Assistant | 205 E. First, Corning, NY 14830 | 2012-05-11 |
| 1275802464 | Anne Bethany Stefanini | Registered Nurse | 36 Mcmahon Avenue, Corning, NY 14830 | 2011-12-19 |
| 1548538119 | Elizabeth Ruth Costello | Registered Nurse | 11 West Third Street, Corning Free Academy, Corning, NY 14830 | 2011-12-09 |
| 1760769418 | Elizabeth Regina Feulner | Registered Nurse | 143 Princton Ave, Northside Blodgett Middle School, Corning, NY 14830 | 2011-11-09 |
| 1073823423 | Joyce Berliner | Occupational Therapist | 33 Denison Parkway West, Corning, NY 14830 | 2010-10-19 |
| 1285880625 | Angie L. Degraff-dacey | Licensed Practical Nurse | 160 Florentia Ln E, Corning, NY 14830 | 2008-08-18 |
| 1003098393 | Marcia Louise Ritter | Pharmacist | 601 West Pulteney Street, Corning, NY 14830 | 2007-11-29 |
| 1023203247 | Suzan S Fenstermacher | Physician Assistant | 88 Tioga Ave., Suite 102, Corning, NY 14830 | 2007-09-11 |
| 1205047313 | Katherine Ann Colyer | Physical Therapist | 11849 East Corning Rd, Suite 108, Corning, NY 14830 | 2007-05-24 |
| Find all providers in zip 14830 | ||||
| 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 |
|---|---|---|---|---|
| 1104482447 | Victoria Blaker | Physician Assistant | 10834 Ridgeview Acres Rd, Corning, NY 14830-9535 | 2019-05-13 |
| 1356615272 | Allison Marie Wetzel | Physician Assistant | 700 Davis Ave, Corning, IA 50841-1419 | 2012-02-24 |
| 1023203247 | Suzan S Fenstermacher | Physician Assistant | 88 Tioga Ave., Suite 102, Corning, NY 14830 | 2007-09-11 |
| 1144272766 | Darlene M Androus Junk | Physician Assistant | 2126 Solano Street, Corning, CA 96021 | 2006-05-16 |
| 1790755775 | Robin Lynne Kent | Physician Assistant | Corning Hospital, 176 Denison Parkway East, Corning, NY 14830 | 2006-01-24 |
| 1225008352 | Sarah Cooper Boyle | Physician Assistant | 176 Denison Parkway, East Corning Hospital, Corning, NY 14830 | 2006-01-23 |
| 1003807736 | Diane I Legendre | Physician Assistant | 144 E 1st St, Corning, NY 14830-2711 | 2005-11-02 |
| 1285186320 | Jacqueline Czwojdak | Physician Assistant | 88 E Tioga Ave Ste 102, Corning, NY 14830-2882 | 2016-10-25 |
| 1215330709 | Talia Calabro | Physician Assistant | 130 Center Way, Corning, NY 14830-2255 | 2014-09-29 |
| 1417298225 | Tobin Scott Duisenberg | Physician Assistant | 155 Solano St, Corning, CA 96021-3511 | 2013-03-05 |
| Find all providers in CORNING | ||||
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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.