Active NPI
Fanta Gassama
- Registered Nurse
- Charlotte, NC
National Provider Identifier
1093378390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 284465
- Practice address
- 8801 J M Keynes Dr Ste 230
Charlotte, NC 28262-5514 - Phone
- (704) 549-1700
- NPI assigned
- Apr 22, 2019
- Last updated
- Apr 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 284465 | NC | Primary |
Addresses
Primary practice location
8801 J M Keynes Dr Ste 230
Charlotte, NC 28262-5514
Mailing address
8801 J M Keynes Dr Ste 230
Charlotte, NC 28262-5514
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000044608353 | Other | NC | DRIVER'S LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jschellhorn@bayada.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 284465 | NC | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Expert Care at Home | Current | Accepting new patients | |
| Bayada Home Health Care, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- In Home Supportive Care Agency
- Charlotte, NC
- NPI 1255035804
-
- Home Health Agency
- Charlotte, NC
- NPI 1285661785
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555891200000",
"number": "1093378390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8801 J M KEYNES DR STE 230",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282625514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8801 J M KEYNES DR STE 230",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282625514",
"telephone_number": "704-549-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GASSAMA",
"first_name": "FANTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-22",
"last_updated": "2019-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "284465",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "000044608353",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jschellhorn@bayada.com",
"affiliation": "N",
"address_1": "8801 J M Keynes Dr Ste 230",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282625514",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Charlotte, NC
- Philip Dillon Gaskins, O.D.
- Silueta Gaspar
- Michael Marion Gaspari, M.D.
- David Adam Gass, MD
- Lauren Blakey Gass, LAT, ATC, CSCS
- Julie Ann Gast, PT, DPT
- Carli Madison Gastley, PMHNP-BC
- Gaston Family Health Services Inc (Kintegra at Turning Point Academy MCS)
- Gaston Family Health Services Inc (Kintegra at Rama Road Elementary)
- Gaston Family Health Services Inc (Kintegra at Turning Point Middle)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.