NPIMap

Individual provider Active NPI

Gordon Roberts McDevitt Jr., MD

  • Diagnostic Radiology Physician
  • Clinton, NC
National Provider Identifier
1073511234
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
9400579 Issued in NC
Practice address
409C Cooper Dr
Clinton, NC 28328-2817
Phone
(910) 592-8070
Fax
(910) 592-8549
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 9400579 NC Primary

Addresses

Primary practice location

409C Cooper Dr
Clinton, NC 28328-2817

Mailing address

PO Box 619
Clinton, NC 28329-0619
Phone (910) 592-8070

Other practice location 1

700 E Morehead St Ste 300
Charlotte, NC 28202-2742
Phone (704) 362-5391

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
I20100805001168 NC Practitioner - Diagnostic Radiology 2466591888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Jefferson Medical College of Thomas Jefferson University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians

Practice addresses (Care Compare)

409 C Cooper Dr
Clinton, NC 28328-2817
Phone (910) 592-8070

925 S Long Dr
Rockingham, NC 28379-4835
Phone (704) 334-7800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
61.52 of 100Reported as individual
Quality
93.8
Improvement activities
0
Cost
79.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9400579NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Imaging Services LLC CurrentSince Dec 6, 2022 Accepting new patients
Charlotte Radiology P a CurrentSince Aug 1, 2019 Accepting new patients
Carolinas Imaging Services, LLC CurrentSince Mar 14, 2024 Accepting new patients
Union Medical Services LLC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Clinton X-Ray Associates, PA Diagnostic Radiology CurrentSince Apr 1, 1999 Accepting new patients

Locations

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

12335 N Community House Rd
Ste B
Charlotte, NC 28277

409C Cooper Dr
Clinton, NC 28328
Phone (910) 592-8070

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

724 Aubrey Bell Dr
Matthews, NC 28105
Phone (704) 295-3550

925 S Long Dr
Rockingham, NC 28379
Phone (910) 417-3000

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 and National Provider Directory roles.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1073511234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 619",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283290619",
            "telephone_number": "910-592-8070",
            "fax_number": "910-592-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409C COOPER DR",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282817",
            "telephone_number": "910-592-8070",
            "fax_number": "910-592-8549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 E Morehead St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282022742",
            "country_code": "US",
            "telephone_number": "704-362-5391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDEVITT",
        "first_name": "GORDON",
        "middle_name": "ROBERTS",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "9400579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

Verify at the official NPI Registry.