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CHRISANNE GORDON MD NPI 1962896969


NPI Information

NPI: 1962896969
Provider Name: CHRISANNE GORDON, MD
Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
500 LONDON AVENUE
MARYSVILLE, OH
ZIP 43040
Phone: (937) 578-2255
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CHRISANNE GORDON, MD is a rehabilitation clinic center in Marysville, OH. CHRISANNE GORDON, MD NPI is 1962896969. The provider is registered as an organization entity type.

The provider's business location address is:

500 LONDON AVENUE
MARYSVILLE, OH
ZIP 43040
Phone: (937) 578-2255

The provider's authorized official is Chrisanne Gordon .
The authorized official title is Physician and has the following contact phone number (937) 578-2255.

The enumeration date for this NPI number is 3/27/2015 and was last updated on 3/27/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0400XClinic/CenterRehabilitation35042915OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10707328MEDICAIDOHIO
2GO0462671MEDICARE UPINOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.