Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Gavin Blair Gore

Individual provider Diagnostic Radiology Physician · NPI 1316189608

Mr. Gavin Blair Gore is a Diagnostic Radiology in Leesburg, Virginia. Qualified in 2009, 17 years ago. Practices with MRI of Reston, LP, a 15-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina and Virginia.

Years since qualifying
17
Licensed in
NC, VA
In the registry since
2009
Specialties on file
3
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Practice location Address checks out

19500 Sandridge Way Ste 420
Leesburg, VA 20176-3467
Phone: (571) 375-8601
Fax: (571) 223-6773
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Medical Center Boulevard, Winston-Salem, NC 27103-2705 — (336) 716-6388

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 0101258174 (VA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 2013-02510 (NC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1316189608
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 1, 2009
Last updated in NPPESNovember 29, 2022
Certification dateNovember 29, 2022
Mailing address224-D Cornwall Street, Nw, Suite 403, Leesburg, VA 20176-2704

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Mri Of Reston, Lp — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Leesburg