GASTONIA MEDICAL SPECIALTY CLINIC PA (NPI# 1023048279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023048279 |
| Entity Type | Organization |
| Organization Name | GASTONIA MEDICAL SPECIALTY CLINIC PA |
| Practice Address |
1021 X Ray Dr Gastonia NC 28054-7489 |
| Practice Telephone | 7048672341 |
| Practice Fax Number | 7048679019 |
| Mailing Telephone | 7048672341 |
| Mailing Fax Number | 7048679019 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2014-10-08 |
| Authorized Official Name | MIKELL J JARRATT (CORPORATE OFFICER - PRESIDENT) |
| Authorized Official Telephone | 7048672341 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NPA701 | 05 | |
| NC | 5920537 | 05 | |
| NC | RAILROAD MEDICARE | CC5252 | 01 |
| NC | BCBSNC GROUP PROVIDER # | 01627 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114221181 | Gastonia Medical Specialty Clinic Pa | Durable Medical Equipment & Medical Supplies | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2011-01-05 |
| Street Address |
1021 X RAY DR |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-7489 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265429864 | Janet Winslow Kelchner | Nurse Practitioner | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2005-09-29 |
| 1538624317 | Megan Wray Self | Nurse Practitioner | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2019-02-05 |
| 1841786316 | Rebecca Shavers | Nurse Practitioner | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2018-07-07 |
| 1205232337 | Emily Barker Stallard | Nurse Practitioner | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2014-11-18 |
| 1639596851 | Lashonda Barnette | Nurse Practitioner | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2014-03-26 |
| 1538504451 | April Marie Mahrle-henson | Nurse Practitioner | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2013-05-06 |
| 1114290277 | Courtney Mccarty Day | Nurse Practitioner | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2012-02-20 |
| 1114221181 | Gastonia Medical Specialty Clinic Pa | Durable Medical Equipment & Medical Supplies | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2011-01-05 |
| 1740213263 | Anup Banerjee | Internal Medicine | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2006-07-08 |
| 1497785604 | Mikell J Jarratt | Internal Medicine | 1021 X Ray Dr, Gastonia, NC 28054-7489 | 2006-07-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861051591 | Modern Medical Group Pllc | Internal Medicine | 936 Cox Rd Ste A, Gastonia, NC 28054-3456 | 2019-06-06 |
| 1093230336 | Gastonia Wellness & Long Term Care Pa | Internal Medicine | 1021 X Ray Dr Ste B, Gastonia, NC 28054-7489 | 2017-08-08 |
| 1639559180 | Anna Marshall | Internal Medicine | 2544 Court Dr Ste F, Gastonia, NC 28054-3450 | 2015-05-30 |
| 1801275706 | Bankim Udayan Patel | Internal Medicine | 2711 X Ray Dr Ste 3106, Gastonia, NC 28054-7491 | 2015-05-26 |
| 1013313519 | Vance Internal Medicine | Internal Medicine | 3624 Easthampton Dr, Gastonia, NC 28056-8944 | 2014-11-10 |
| 1003131020 | Robert Barringer | Internal Medicine | 3021 Village Ridge Dr, Gastonia, NC 28056-7945 | 2010-04-01 |
| 1891956819 | Union Medical Clinic, PC | Internal Medicine | 1574 Union Rd, Suite A, Gastonia, NC 28054-5633 | 2008-06-23 |
| 1164610580 | Bc Wall Medical Group Pa | Internal Medicine | 1574 Union Road, A, Gastonia, NC 28054-5633 | 2007-10-10 |
| 1740314053 | Guhapriya Palaniswamy | Internal Medicine | 442 E Long Ave, Pulmonary Clinic of The Carolinas, Gastonia, NC 28054-2527 | 2007-03-16 |
| 1447382379 | Rodger W Lefler | Internal Medicine | 660 Summit Crossing Pl Ste 301, Gastonia, NC 28054-2181 | 2007-03-09 |
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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.