Individual provider Active NPI

Thomas Gaston, M.D.

  • Specialist
  • Statesville, NC
National Provider Identifier
1114905601
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
557 Brookdale Dr
Statesville, NC 28677-4107
Phone
(704) 838-5166
NPI assigned
Jan 4, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NC Primary

Addresses

Primary practice location

557 Brookdale Dr
Statesville, NC 28677-4107

Mailing address

548 Brookdale Dr
Statesville, NC 28677-4108
Phone (704) 872-6122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060214000060 NC Practitioner - Diagnostic Radiology 0547275489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of Ny Upstate Medical University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of North Carolina PCGroup PAC ID 8628507811, 36 clinicians

Practice addresses (Care Compare)

525 W Swannanoa Ave
Liberty, NC 27298-3136
Phone (469) 757-1042

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200501866NCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of North Carolina PC CurrentSince Jul 8, 2025 Accepting new patients

Locations

525 W Swannanoa Ave
Liberty, NC 27298
Phone (336) 622-4850

1540 E Broad St
Statesville, NC 28625
Phone (704) 230-4382

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114905601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774108",
            "telephone_number": "704-872-6122",
            "fax_number": "704-872-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774107",
            "telephone_number": "704-838-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTON",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.