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2910 E Franklin Blvd, 1 Gastonia NC 28056-7725 | |
| (704) 648-0460 | |
| (855) 446-7146 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 2910 E Franklin Blvd, 1, Gastonia, North Carolina |
| Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
| Authorized Official Contact | 4074477120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000 | 2910 E Franklin Blvd, 1 Gastonia NC 28056-7725 Ph: (704) 648-0460 |
| NPI Number | 1073034625 |
|---|---|
| Provider Enumeration Date | 07/05/2017 |
| Last Update Date | 07/03/2024 |
| Medicare PECOS PAC ID | 2264708486 |
|---|---|
| Medicare Enrollment ID | O20171016002152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073034625 | NPI | - | NPPES |
| Provider Name | Kanchan P Mcmahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649258492 PECOS PAC ID: 5991711913 Enrollment ID: I20060301000189 |
| Provider Name | Amir Z Ansari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477507713 PECOS PAC ID: 0345234282 Enrollment ID: I20070730000327 |
| Provider Name | Brian Anthony Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619949617 PECOS PAC ID: 7911943881 Enrollment ID: I20080521000676 |
| Provider Name | Christel N Keisler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831384189 PECOS PAC ID: 2668524752 Enrollment ID: I20090721000529 |
| Provider Name | Elie M Osta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861468902 PECOS PAC ID: 4284697376 Enrollment ID: I20100728000676 |
| Provider Name | Ahunna N Okwubunka Anyim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023216199 PECOS PAC ID: 5092803866 Enrollment ID: I20130823000458 |
| Provider Name | Susanna Marie Shepard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003992058 PECOS PAC ID: 0244479913 Enrollment ID: I20131008000156 |
| Provider Name | Christina Xiong Linart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710224332 PECOS PAC ID: 3971744038 Enrollment ID: I20160224001415 |
| Provider Name | Barron I Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972947679 PECOS PAC ID: 9335386010 Enrollment ID: I20170425001128 |
| Provider Name | Marion Maria Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821526526 PECOS PAC ID: 9638449721 Enrollment ID: I20170722000072 |
| Provider Name | Miesha Kindell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306202742 PECOS PAC ID: 7911201926 Enrollment ID: I20171010003125 |
| Provider Name | Brandi Lynn Stone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326416835 PECOS PAC ID: 5799047379 Enrollment ID: I20180319002050 |
| Provider Name | Jaicie Nadine Congress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497242630 PECOS PAC ID: 4082969944 Enrollment ID: I20180618000152 |
| Provider Name | Erica Lache' Savage-jeter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275657694 PECOS PAC ID: 9739234584 Enrollment ID: I20180709000632 |
| Provider Name | Andrew W King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932588803 PECOS PAC ID: 4587953153 Enrollment ID: I20181004001887 |
| Provider Name | Kavithamani Mallan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891257903 PECOS PAC ID: 1658602404 Enrollment ID: I20191009003209 |
| Provider Name | Damaris Wanjiku Gichuhi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245889625 PECOS PAC ID: 6608201678 Enrollment ID: I20200122000020 |
| Provider Name | Roberta Capp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548451669 PECOS PAC ID: 2264601939 Enrollment ID: I20200618002369 |
| Provider Name | Jocelyn Alisa Sampson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427524958 PECOS PAC ID: 8921419557 Enrollment ID: I20201202002662 |
| Provider Name | Lorie Jolly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043638554 PECOS PAC ID: 2860754868 Enrollment ID: I20210107000154 |
| Provider Name | Lindsay Patlewicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841523784 PECOS PAC ID: 2163569187 Enrollment ID: I20210111001211 |
| Provider Name | Gregory Michael Lavins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912402769 PECOS PAC ID: 0749537025 Enrollment ID: I20210720003489 |
| Provider Name | Chris C Que |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669432043 PECOS PAC ID: 5496846248 Enrollment ID: I20210729004065 |
| Provider Name | Heidi S Cammer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467127886 PECOS PAC ID: 7214335942 Enrollment ID: I20211012000290 |
| Provider Name | Kristin Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912667072 PECOS PAC ID: 6406248558 Enrollment ID: I20220121001421 |
| Provider Name | Kam Wei Chan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891759510 PECOS PAC ID: 9234328238 Enrollment ID: I20220121001975 |
| Provider Name | Robert Hanlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568410280 PECOS PAC ID: 2264425529 Enrollment ID: I20220124000028 |
| Provider Name | Marcella Ann Tabor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184681579 PECOS PAC ID: 0244134013 Enrollment ID: I20220124000122 |
| Provider Name | Stephanie Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861460883 PECOS PAC ID: 4284620774 Enrollment ID: I20220125000214 |
| Provider Name | Alagusivakumari Rameshbabu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003850389 PECOS PAC ID: 9739071341 Enrollment ID: I20220512002809 |
| Provider Name | Lakeshia Antoinette Entzminger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215215934 PECOS PAC ID: 8426296047 Enrollment ID: I20220513001137 |
| Provider Name | Amy Beth Raz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881669315 PECOS PAC ID: 2668645516 Enrollment ID: I20221021001532 |
| Provider Name | Brittany Bowling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669042149 PECOS PAC ID: 0648646000 Enrollment ID: I20221026002319 |
| Provider Name | Kusum Paudel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710608641 PECOS PAC ID: 5698145340 Enrollment ID: I20221221002686 |
| Provider Name | Levonne Mitchell Samon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770542813 PECOS PAC ID: 9032176276 Enrollment ID: I20230214001673 |
| Provider Name | Regi Jose Vadassery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275562035 PECOS PAC ID: 3971975251 Enrollment ID: I20230215000217 |
| Provider Name | Nana Yaa Serwaa Addai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114539814 PECOS PAC ID: 2163800194 Enrollment ID: I20230504001362 |
| Provider Name | Vijaya Surekha Bhamidipati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679769863 PECOS PAC ID: 5698843761 Enrollment ID: I20230608003022 |
| Provider Name | Jeff Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588968903 PECOS PAC ID: 8729305156 Enrollment ID: I20230621002221 |
| Provider Name | Jalecia Maria Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164189874 PECOS PAC ID: 1658725882 Enrollment ID: I20230921003169 |
| Provider Name | Jorge Merino Herrera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306332739 PECOS PAC ID: 1052715588 Enrollment ID: I20231010000787 |
| Provider Name | Jerell Diego Chua |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1962637827 PECOS PAC ID: 7810149721 Enrollment ID: I20231120003313 |
| Provider Name | Sheila Ann Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164871166 PECOS PAC ID: 9739538083 Enrollment ID: I20231212001206 |
| Provider Name | Zuhair Ahmed Abualrihy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720240682 PECOS PAC ID: 4981856564 Enrollment ID: I20240515004410 |
| Provider Name | Cecile Catalan Dadivas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609822865 PECOS PAC ID: 7214975598 Enrollment ID: I20240621001556 |
| Provider Name | Eric J Pederson |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1679001945 PECOS PAC ID: 7113295973 Enrollment ID: I20240917001896 |
| Provider Name | Mary Simmons Burgess |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861519787 PECOS PAC ID: 7810225950 Enrollment ID: I20241021003901 |
Vance Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3624 Easthampton Dr, Gastonia, NC 28056 Phone: 704-564-1312 Fax: 310-348-0201 | |
Gastonia Medical Specialty Clinic Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1021 X Ray Dr, Gastonia, NC 28054 Phone: 704-867-2341 Fax: 704-867-9019 | |
Shaped Health And Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2020 Remount Rd Ste E-105, Gastonia, NC 28054 Phone: 704-931-8286 | |
Gaston Family Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 137 Stowe Rd, Gastonia, NC 28056 Phone: 704-836-9112 Fax: 704-824-4715 | |
Southern Pulmonary Center, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 Cox Rd, Ste B, Gastonia, NC 28054 Phone: 704-868-3411 Fax: 704-865-9722 | |