NPIMap

Individual provider Active NPI

Gannon Neil Millsaps, PA-S

  • Physician Assistant
  • Huntersville, NC
National Provider Identifier
1023845054
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15866 Issued in NC
Practice address
9800 Kincey Ave Ste 150
Huntersville, NC 28078-8405
Phone
(704) 799-4909
Fax
(704) 799-7695
NPI assigned
Sep 14, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-15866 NC Primary

Addresses

Primary practice location

9800 Kincey Ave Ste 150
Huntersville, NC 28078-8405

Mailing address

3158 Freedom Dr Ste 3102
Charlotte, NC 28208-0014
Phone (704) 971-7099

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gmillsaps82767@direct.acumenmd.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251117002658 NC Practitioner - Physician Assistant 1153812235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metrolina Nephrology Associates PAGroup PAC ID 8022916600, 85 clinicians

Practice addresses (Care Compare)

9800 Kincey Ave
Suite 150
Huntersville, NC 28078-8405
Phone (704) 766-1630

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-15866NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metrolina Nephrology Associates, PA CurrentSince Oct 6, 2025 Accepting new patients

Locations

3158 Freedom Dr
Ste 3102
Charlotte, NC 28208
Phone (704) 731-6857

2544 Court Dr
Ste F
Gastonia, NC 28054
Phone (704) 864-8302

9800 Kincey Ave
Ste 150
Huntersville, NC 28078
Phone (704) 766-1630

Organizations & group practices 1

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

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1726272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1023845054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3158 FREEDOM DR STE 3102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282080014",
            "telephone_number": "704-971-7099",
            "fax_number": "704-971-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 KINCEY AVE STE 150",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280788405",
            "telephone_number": "704-799-4909",
            "fax_number": "704-799-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLSAPS",
        "first_name": "GANNON",
        "middle_name": "NEIL",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-14",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmillsaps82767@direct.acumenmd.com",
            "affiliation": "N",
            "endpointDescription": "Acumen Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CED",
            "address_1": "9800 Kincey Ave Ste 150",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280788405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.