Individual provider Active NPI

Kapil Gupta, MD

  • Dermatopathology (Pathology) Physician
  • Concord, NC
National Provider Identifier
1104802008
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
200400504 Issued in NC
Practice address
335 Penny LN
Concord, NC 28025-1221
Phone
(704) 784-5901
Fax
(704) 721-0413
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 200400504 NC Primary

Addresses

Primary practice location

335 Penny LN
Concord, NC 28025-1221

Mailing address

335 Penny LN
Concord, NC 28025-1221
Phone (704) 784-5901

Other identifiers 2

IdentifierTypeStateIssuer
5900528MedicaidNC
P00232695OtherNCMEDICARE RAILROAD

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200400504NCMDDermatopathology (Pathology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1104802008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-784-5901",
            "fax_number": "704-721-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-784-5901",
            "fax_number": "704-721-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "KAPIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "NC",
            "license": "200400504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900528",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00232695",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.