Individual provider Active NPI

Adnan Ekram, M.D.

  • Family Medicine Physician
  • Gastonia, NC
National Provider Identifier
1023400249
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2015-01579 Issued in NC
Practice address
2555 Court Dr
Suite 270
Gastonia, NC 28054-2134
Phone
(704) 834-4390
Fax
(704) 834-3274
NPI assigned
Feb 25, 2015
Last updated
Jun 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2015-01579 NC Primary
Family Medicine Physician 207Q00000X 073226 GA

Addresses

Primary practice location

2555 Court Dr
Suite 270
Gastonia, NC 28054-2134

Mailing address

2555 Court Dr
Suite 270
Gastonia, NC 28054-2134
Phone (704) 834-4390

Other identifiers 2

IdentifierTypeStateIssuer
AN2522MedicaidSC
1023400249MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150921002781 NC Practitioner - Internal MedicinePractitioner - Family Practice 1850608050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
073226GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Family Medicine Current Accepting new patients
Caromont Medical Group, Inc. CurrentSince Aug 15, 2015 Accepting new patients
Caromont Medical Group Inc Family Medicine CurrentSince Aug 15, 2015 Accepting new patients
Columbus Regional Health Network Family Medicine Past Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

2555 Court Dr
Ste 270
Gastonia, NC 28054
Phone (704) 671-7650

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1023400249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 COURT DR",
            "address_2": "SUITE 270",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542134",
            "telephone_number": "704-834-4390",
            "fax_number": "704-834-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR",
            "address_2": "SUITE 270",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542134",
            "telephone_number": "704-834-4390",
            "fax_number": "704-834-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKRAM",
        "first_name": "ADNAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-25",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2015-01579",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "073226",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN2522",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023400249",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.