Individual provider Active NPI

Kyle E Gaisford, LCSA-A

  • Addiction (Substance Use Disorder) Counselor
  • Hickory, NC
National Provider Identifier
1063116507
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
28300 Issued in NC
Practice address
1170A Fairgrove Church Rd
Hickory, NC 28602-9695
Phone
(828) 464-1172
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 28300 NC Primary

Addresses

Primary practice location

1170A Fairgrove Church Rd
Hickory, NC 28602-9695

Mailing address

1170A Fairgrove Church Rd
Hickory, NC 28602-9695
Phone (828) 464-1172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28300NCMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1063116507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170A FAIRGROVE CHURCH RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029695",
            "telephone_number": "828-464-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170A FAIRGROVE CHURCH RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029695",
            "telephone_number": "828-464-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAISFORD",
        "first_name": "KYLE",
        "middle_name": "E",
        "credential": "LCSA-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "28300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.