Individual provider Active NPI

Gladys Elena Viera, MD

  • Pediatrics Physician
  • Rocky Mount, NC
National Provider Identifier
1164069415
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2024-01157 Issued in NC
Practice address
1041 Noell LN
Rocky Mount, NC 27804-2058
Phone
(252) 316-8205
NPI assigned
Dec 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD.45375 AL
Pediatrics Physician 208000000X 2024-01157 NC Primary

Addresses

Primary practice location

1041 Noell LN
Rocky Mount, NC 27804-2058

Mailing address

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Phone (252) 962-6999

Other practice location 1

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Phone (252) 962-6999

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
I20240827002700 NC Practitioner - Pediatric Medicine 8527462787 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.45375ALMDPediatrics Physician
2024-01157NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Opportunities Industrialization Center, Inc CurrentSince Jul 29, 2024 Accepting new patients
Opportunities Industrialization Center, Inc CurrentSince Jul 29, 2024 Accepting new patients
Opportunities Industrialization Center, Inc Past Accepting new patients

Locations

300 N Grace St
Rocky Mount, NC 27804
Phone (252) 210-9856

1041 Noell Ln
#B
Rocky Mount, NC 27804
Phone (252) 962-3450

111 S Fairview Rd
Rocky Mount, NC 27801
Phone (252) 212-3486

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": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1164069415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 CURTIS ELLIS DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042237",
            "telephone_number": "252-962-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 NOELL LN",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042058",
            "telephone_number": "252-316-8205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2460 Curtis Ellis Dr",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278042237",
            "country_code": "US",
            "telephone_number": "252-962-6999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIERA",
        "first_name": "GLADYS",
        "middle_name": "ELENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "MD.45375",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2024-01157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.