KENNETH D GORDON MD
NPI 1871549204
Internal Medicine in Lagrange, GA

Active since May 26, 2006PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
1602 VERNON RD, SUITE 400, LAGRANGE, GA 30240(706) 882-9341(706) 884-0131 Get Directions Write a Review

NPPES record last updated: April 15, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kenneth D Gordon Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH D GORDON MD (NPI 1871549204) is an individual internal medicine provider in Lagrange, Georgia, licensed in Georgia (037816) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Wellstar West Georgia Medical Center, and is a graduate of Tulane University School Of Medicine (1988).

NPPES Registry Identity

NPI1871549204
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameKENNETH D GORDONCredential: MD
Location Address1602 VERNON RD, SUITE 400Lagrange, GA 30240-4100
Mailing Address1602 Vernon Rd, Suite 400Lagrange, GA 30240-4100 · (706) 882-9341 · Fax (706) 884-0131
Fax(706) 884-0131
Sole ProprietorNo
Medical School CMSTulane University School Of MedicineGraduated 1988
Enumeration DateMay 26, 2006
Last NPPES UpdateApril 15, 2024
NPPES CertifiedApril 15, 2024
NPI 1871549204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in GA · 037816
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1602 VERNON RD, Lagrange, GA 30240

Other Identifiers 1

Medicaid100064937AGA

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kenneth D Gordon Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527089440
PECOS Enrollment IDI20051207000658, I20060627000040
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 45

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
1,168 services119 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
745 services326 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
642 services304 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
620 services113 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
528 services298 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
515 services296 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wellstar West Georgia Medical Center

Acute Care Hospitals · Lagrange, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110016
Location1514 Vernon RoadLagrange, GA 30240 · Troup County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30240 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 14

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
14 suppliers62 claims165 services$6.29 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
11 suppliers24 claims35 services$0.94 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers13 claims13 services$117.41 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers15 claims34 services$42.44 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
4 suppliers13 claims13 services$68.45 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
3 suppliers17 claims17 services$19.46 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
1602 VERNON RD, STE 400
LAGRANGE, GA 30240
Internal Medicine
1602 VERNON RD, STE 400
LAGRANGE, GA 30240
Nurse Practitioner (Primary Care)
1602 VERNON RD, SUITE 400
LAGRANGE, GA 30240
Obstetrics & Gynecology
1602 VERNON RD, SUITE 200
LAGRANGE, GA 30240
Internal Medicine
1602 VERNON RD, STE 400
LAGRANGE, GA 30240
Internal Medicine
1602 VERNON RD, STE 400
LAGRANGE, GA 30240
Internal Medicine
1602 VERNON RD, STE 400
LAGRANGE, GA 30240
Internal Medicine
1602 VERNON RD, SUITE 400
LAGRANGE, GA 30240

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Gordon's NPI number?

The NPI number for Kenneth Gordon is 1871549204. It was assigned to this individual provider in the NPPES registry on May 26, 2006.

Where is Kenneth Gordon located?

Kenneth Gordon practices at 1602 Vernon Rd Suite 400, Lagrange, GA 30240. The listed phone number is (706) 882-9341.

What is Kenneth Gordon's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kenneth Gordon enrolled in Medicare?

Yes. Kenneth Gordon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kenneth Gordon accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Kenneth Gordon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kenneth Gordon affiliated with any hospitals?

According to CMS data, Kenneth Gordon is affiliated with Wellstar West Georgia Medical Center.

When was this NPI record last updated?

The NPPES record for Kenneth Gordon was last updated on April 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.