Individual provider Active NPI

David Gregory Gaines II

  • Physician Assistant
  • Demorest, GA
National Provider Identifier
1053737692
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
541 Historic Highway 441
Demorest, GA 30535-0037
Phone
(706) 754-3113
NPI assigned
Mar 6, 2014
Last updated
Mar 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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 NU Primary

Addresses

Primary practice location

541 Historic Highway 441
Demorest, GA 30535-0037

Mailing address

1801 NW 66TH Ave
Plantation, FL 33313-4571
Phone (706) 754-3113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140702000314 GA Practitioner - Physician Assistant 6002031218 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.02 of 100Reported as group
Quality
91.38
Improvement activities
40
Cost
79.01

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Aug 14, 2024 Accepting new patients
Cep America LLC CurrentSince Aug 14, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-1072

2801 DeKalb Medical Pkwy
Stonecrest, GA 30058
Phone (404) 501-5374

Interoperability endpoints

  • Direct secure messaging: dgaines2625209@direct.trinity-health.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1053737692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 NW 66TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333134571",
            "telephone_number": "706-754-3113",
            "fax_number": "865-291-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 HISTORIC HIGHWAY 441",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "305350037",
            "telephone_number": "706-754-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "DAVID",
        "middle_name": "GREGORY",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Demorest, GA

Sources for this page

Verify at the official NPI Registry.