Individual provider Active NPI

Gabriella Athena Vandenberg, DNP

  • Family Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1154022903
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5021429 Issued in NC
Practice address
2544 Court Dr Ste G
Gastonia, NC 28054-3450
Phone
(704) 854-9990
NPI assigned
Mar 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5021429 NC Primary

Addresses

Primary practice location

2544 Court Dr Ste G
Gastonia, NC 28054-3450

Mailing address

PO Box 744786
Atlanta, GA 30374-4786

Other practice location 1

235 Woodlands Way Unit 10
Calabash, NC 28467-2331
Phone (518) 944-9620

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625000667 NC Practitioner - Nurse Practitioner 4183136120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

2544 Court Dr
Gastonia, NC 28054-3450

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5021429NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc CurrentSince Apr 27, 2025 Accepting new patients
Caromont Medical Group Inc CurrentSince Apr 27, 2025 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients

Locations

2544 Court Dr
Ste G
Gastonia, NC 28054
Phone (704) 854-9990

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

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.

Hospital & facility affiliations 1

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": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1154022903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 COURT DR STE G",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543450",
            "telephone_number": "704-854-9990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Woodlands Way Unit 10",
            "address_purpose": "LOCATION",
            "city": "Calabash",
            "state": "NC",
            "postal_code": "284672331",
            "country_code": "US",
            "telephone_number": "518-944-9620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "GABRIELLA",
        "middle_name": "ATHENA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.