Gastonia Physician Services, PLLC
Organization Active NPI Emergency Medicine Physician · Belmont, NC
NPI 1104644004 · NPPES record last updated Aug 14, 2026
Key facts
- NPI
- 1104644004
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- GASTONIA PHYSICIAN SERVICES, PLLC
- Practice address
- 1000 Caromont Pkwy
Belmont, NC 28012-0140 - Phone
- (704) 834-2000
- NPI assigned
- Sep 30, 2024
- Organization subpart
- No
Authorized official
- Name
- Kim H Larsen
- Title
- VP, Credentialing
- Phone
- (770) 874-5400
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 1
Practitioners 277
-
Izabella Shea Abookire, PA-C
-
Yousif Alkadhi, M.D.
-
Elias Ameen Awad, M.D.
-
Fiona Okwuchi Azubuike, M.D.
-
Alexandra Rose Barre, PA-C
-
Vanessa Leigh Berich, PA-C
-
Christopher Scott Bewley, M.D.
-
Raymond Joseph Biersbach, M.D.
-
John Bream, M.D.
-
Jonathan Brower, MD
-
Alvina Elaine Bryant, FNP-C
-
Scott Centers, MD
-
Derek Kelly Coburn, P.A.
-
Melissa Cohen, MMS, PA-C
-
Ian Oluremilekun Cole, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140730002523 | NC | Part B Supplier - Clinic/Group Practice | 3870719602 |
Receives reassigned benefits from 280 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Belmont, NC; Gastonia, NC; Mt Holly, NC |
National Provider Directory
- Tax ID family
- Gastonia Physician Services PLLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
1000 Caromont Pkwy
Belmont, NC 28012-0140
Mailing address
PO Box 21107
Belfast, ME 04915-4108
Phone (770) 874-5400
Other providers in Belmont, NC
- Gaston Family Health Services, Inc.
- Gaston Family Health Services, Inc.
- Gaston Family Health Services, Inc.
- Gaston Family Health Services, Inc.
- Gaston Hearing Center PLLC
- Gastonresidential Services, Icf/Mr, Inc.
- Christopher Anthony Gazdik
- Claudina Ghianni
- Kenya Gleaton
- Marilyn G Glinka
All providers in Belmont, NC · Emergency Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.