Individual provider Active NPI

Billie Jo Dagenhart, NP-C

  • Family Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1043756794
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
179261 Issued in NC
Practice address
640 Summit Crossing PL
Suite 200
Gastonia, NC 28054-2138
Phone
(704) 671-5400
Fax
(704) 671-5420
NPI assigned
Jan 18, 2017
Last updated
Jan 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 179261 NC
Family Nurse Practitioner 363LF0000X 179261 NC Primary

Addresses

Primary practice location

640 Summit Crossing PL
Suite 200
Gastonia, NC 28054-2138

Mailing address

640 Summit Crossing PL
Suite 200
Gastonia, NC 28054-2138
Phone (704) 671-5400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170530002042 NC Practitioner - Nurse Practitioner 8022385764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
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)

600 W Trade St
Dallas, NC 28034-1543
Phone (980) 834-9170

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
179261NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc CurrentSince Mar 13, 2017 Accepting new patients
Caromont Medical Group Inc CurrentSince Mar 13, 2017 Accepting new patients

Locations

1212 Spruce St
Ste 305A
Belmont, NC 28012
Phone (980) 834-5760

1223 Spruce St
Belmont, NC 28012
Phone (704) 316-2150

910 E Church St
Ste A
Cherryville, NC 28021
Phone (704) 445-0422

600 W Trade St
Dallas, NC 28034
Phone (980) 834-9130

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

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

700 N Main St
Stanley, NC 28164
Phone (704) 263-8945

Organizations & group practices 3

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 6

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": "1484697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1043756794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 SUMMIT CROSSING PL",
            "address_2": "SUITE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542138",
            "telephone_number": "704-671-5400",
            "fax_number": "704-671-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 SUMMIT CROSSING PL",
            "address_2": "SUITE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542138",
            "telephone_number": "704-671-5400",
            "fax_number": "704-671-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGENHART",
        "first_name": "BILLIE JO",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-18",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "179261",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "179261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.