Individual provider Active NPI

Gregory Allen Mantooth, M.D.

  • Plastic Surgery Physician
  • Gastonia, NC
National Provider Identifier
1124029707
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
200101091 Issued in NC
Practice address
937 Cox Rd
Gastonia, NC 28054-3455
Phone
(704) 898-8014
Fax
(704) 898-8018
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 200101091 NC Primary

Addresses

Primary practice location

937 Cox Rd
Gastonia, NC 28054-3455

Mailing address

1072 X Ray Dr Ste B
Gastonia, NC 28054-7488
Phone (704) 671-1094

Other practice location 1

5815 Blakeney Park Dr Ste 100
Charlotte, NC 28277-5732
Phone (704) 542-2220

Other identifiers 1

IdentifierTypeStateIssuer
8912965MedicaidNC

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
I20100809000565 NC Practitioner - Plastic and Reconstructive Surgery 2062545205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Tennessee, HSC, College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Plastic Surgery and Dermatology PAGroup PAC ID 6800875188, 56 clinicians

Practice addresses (Care Compare)

959 Cox Rd
Gastonia, NC 28054-3420
Phone (704) 866-0106

Merit-based Incentive Payment System (MIPS)

Final score
89.65 of 100Reported as group
Quality
91.92
Promoting interoperability
94
Improvement activities
40
Cost
78.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision114
Removal of skin lesions612
Removal or shaving of skin growth1-10
Skin biopsy348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200101091NCMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Piedmont Plastic Surgery and Dermatology PastSince Aug 1, 2001 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1124029707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 X RAY DR STE B",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547488",
            "telephone_number": "704-671-1094",
            "fax_number": "704-671-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 COX RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543455",
            "telephone_number": "704-898-8014",
            "fax_number": "704-898-8018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5815 Blakeney Park Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282775732",
            "country_code": "US",
            "telephone_number": "704-542-2220",
            "fax_number": "704-542-3304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTOOTH",
        "first_name": "GREGORY",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "200101091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912965",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.