Robert Dale Willmore (NPI# 1326042904, PAC ID# 8426950460) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1326042904 |
| PAC ID by PECOS | 8426950460 |
| Professional Enrollment ID | I20151106002106 |
| Full Name | Robert Dale Willmore |
| Organization Legal Name | EASTRIDGE FAMILY MEDICINE |
| Address |
1896 Remount Rd Gastonia NC 28054-7414 |
| Phone Number | 7045123930 |
| Gender | M |
| Credential | PA |
| Graduation Year | 1985 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 2466401666 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340113 | CAROLINAS MEDICAL CENTER/BEHAV HEALTH |
| 340032 | GASTON MEMORIAL HOSPITAL, INC. |
| Address | Phone | Organization |
|---|---|---|
| 1896 Remount Rd, Gastonia, NC 28054-7414 | 7045123930 | EASTRIDGE FAMILY MEDICINE |
| Organization Legal Name | EASTRIDGE FAMILY MEDICINE |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Susan H Capps | Physician Assistant | Eastridge Family Medicine | 1896 Remount Rd, Gastonia, NC 28054-7414 |
| Lewis B Bolin Jr. | Family Medicine | Eastridge Family Medicine | 1896 Remount Rd, Gastonia, NC 28054-7414 |
| Amy L Randolph | Nurse Practitioner | Eastridge Family Medicine | 1896 Remount Rd, Gastonia, NC 28054-7414 |
| Nathan D Funk | Physician Assistant | Eastridge Family Medicine | 1896 Remount Rd, Gastonia, NC 28054-7414 |
| Jennie M Dellinger | Physician Assistant | Eastridge Family Medicine | 1896 Remount Rd, Gastonia, NC 28054-7414 |
| Street Address |
1896 REMOUNT RD |
| City | GASTONIA |
| State | NC |
| Zip | 28054-7414 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Susan H Capps | Physician Assistant | Eastridge Family Medicine | 1896 Remount Rd, Gastonia, NC 28054-7414 |
| Lewis B Bolin Jr. | Family Medicine | Eastridge Family Medicine | 1896 Remount Rd, Gastonia, NC 28054-7414 |
| Amy L Randolph | Nurse Practitioner | Eastridge Family Medicine | 1896 Remount Rd, Gastonia, NC 28054-7414 |
| Nathan D Funk | Physician Assistant | Eastridge Family Medicine | 1896 Remount Rd, Gastonia, NC 28054-7414 |
| Jennie M Dellinger | Physician Assistant | Eastridge Family Medicine | 1896 Remount Rd, Gastonia, NC 28054-7414 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Albert Whitaker Jr. | Family Medicine | 224 S New Hope Rd K, Gastonia, NC 28054-0020 | |
| Leanne R King | Nurse Practitioner | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Kirsten G D Amore | Physical Medicine and Rehabilitation | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Emily B Rayfield | Nurse Practitioner | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| James E Harris Jr. | Physician Assistant | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Julie C Cornwell | Nurse Practitioner | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Lisa B Wilbanks | Nurse Practitioner | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Rebecca H Brown | Family Practice | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Nora D Paysour | Nurse Practitioner | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Sharon L Heinrich | Nurse Practitioner | Hospice of Gaston County Inc | 258 E Garrison Blvd, Gastonia, NC 28054-0460 |
| Find all physicians in zip 28054 | |||
| City | GASTONIA |
| Zip Code | 28054 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | GASTONIA + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.