Kinston Internal Medicine & Geriatrics

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

200901445 Issued in NC

Legal business name

KINSTON INTERNAL MEDICINE & GERIATRICS

Practice address

2508 N Queen St
Kinston, NC 28501-1631

Phone

(252) 208-1965

Fax

(252) 208-1962

NPI assigned

Apr 11, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mobolanle O Gbadamosi, MD

Title

Physician

Phone

(252) 208-1965

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1124384441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 N QUEEN ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285011631",
            "telephone_number": "252-208-1965",
            "fax_number": "252-208-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 N QUEEN ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285011631",
            "telephone_number": "252-208-1965",
            "fax_number": "252-208-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINSTON INTERNAL MEDICINE & GERIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "GBADAMOSI",
        "authorized_official_first_name": "MOBOLANLE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "252-208-1965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "200901445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913338",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO/GBA",
            "identifier": "A936",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kinston Community Health Center, Inc.
• Kinston Dermatology, PA
• Kinston Diagnostic Group PA
• Kinston Digestive Diseases PA
• Kinston Head and Neck Physicians and Surgeons, P.a.
• Kinston Medical Specialists PA
• Kinston Medical Specialists PA
• Kinston Neuroscience, Inc
• Kinston Obstetrical & Gynecological Associates PA
• Kinston Opco, LLC

• Geriatric Medicine (Internal Medicine) Physician in Kinston, NC
• Providers in Kinston, NC by specialty
• Geriatric Medicine (Internal Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.