| Richard Montgomery Jordan, MD | |
| 
					620 Summit Crossing Pl, Suite 106, Gastonia, NC 28054-2176  | |
| (704) 867-8021 | |
| (704) 864-4606 | 
| Full Name | Richard Montgomery Jordan | 
|---|---|
| Gender | Male | 
| Speciality | Radiology - Vascular & Interventional Radiology | 
| Location | 620 Summit Crossing Pl, Gastonia, North Carolina | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1821075508 | NPI | - | NPPES | 
| 72386 | Other | MEDCOST | |
| 47484 | Other | BLUE CROSS BLUE SHIELD | |
| 2137652 | Other | AETNA HMO | |
| 4629496 | Other | AETNA PPO | |
| 8947484 | Medicaid | NC | |
| N30923 | Medicaid | SC | |
| 300068233 | Other | RAILROAD MEDICARE | |
| 1642994 | Other | UNITED HEALTHCARE | |
| 6677 | Other | PARTNERS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 30923 (North Carolina) | Secondary | 
| 2085R0204X | Radiology - Vascular & Interventional Radiology | 30923 (North Carolina) | Primary | 
| Entity Name | Gaston Radiology Pa | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1356324487 PECOS PAC ID: 4082680806 Enrollment ID: O20040902001290  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Richard Montgomery Jordan, MD 620 Summit Crossing Pl, Suite 106, Gastonia, NC 28054-2176 Ph: (704) 867-8021  | Richard Montgomery Jordan, MD 620 Summit Crossing Pl, Suite 106, Gastonia, NC 28054-2176 Ph: (704) 867-8021  | 
Mark Thomas Edge, PHD MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 620 Summit Crossing Pl, Ste 106, Gastonia, NC 28054 Phone: 704-867-8021 Fax: 704-864-4606  | |
Renee Raimondi Deweese, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: Summit Crossing Place, Ste 106, Gastonia, NC 28054 Phone: 704-867-8021 Fax: 704-864-4606  | |
Christopher Johannus Vandermeer, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 620 Summit Crossing Pl, Ste 106, Gastonia, NC 28054 Phone: 704-867-8021 Fax: 704-864-4606  | |
Dr. Richard S Herring, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 620 Summit Crossing Pl Ste 106, Gastonia, NC 28054 Phone: 404-712-4686  | |
Heather Ann Pickford, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 620 Summit Crossing Pl, Ste 106, Gastonia, NC 28054 Phone: 704-867-8021 Fax: 704-864-4606  | |
Christopher William Saltmarsh, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 620 Summit Crossing Pl, Ste 106, Gastonia, NC 28054 Phone: 704-867-8021 Fax: 704-864-4606  | |
Robert William Miller, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 620 Summit Crossing Pl, Ste 106, Gastonia, NC 28054 Phone: 704-867-8021 Fax: 704-864-4606  |