Gabriella Hautala, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1 University Pkwy
High Point, NC 27268-0002

Phone

(336) 841-9000

NPI assigned

Aug 30, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Broad River Physicians Group, LLC

  • Emergency Medicine Physician
  • Summerville, SC
  • NPI 1295443000
  Medicare reassignment

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1083499743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 KEMBLE DR",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015451690",
            "telephone_number": "978-875-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY PKWY",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272680002",
            "telephone_number": "336-841-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUTALA",
        "first_name": "GABRIELLA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen E Haskins, LCSW
• Samantha Alexander Haspel, CNM
• Maleeha Hassan, LCSWA
• Hatteras Family Medicine. P.L.L.C.
• Samantha Hauser, MS, SLP
• Gitana Alicia Havner, M.A.ED, LCMHCA, NCC
• April Hawkins
• Aldene N Hawks, MD
• Chester C. Haworth, MD
• Diane Hayes, CNA II

• Physician Assistant in High Point, NC
• Providers in High Point, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.