Individual provider Active NPI

James A Gainer, DDS

  • Dentist
  • Wilmington, NC
National Provider Identifier
1174576516
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9067 Issued in NC
Practice address
3725 Wrightsville Ave
Ste a
Wilmington, NC 28403-4041
Phone
(910) 799-9699
Fax
(910) 792-9987
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8564 MD
Dentist 122300000X 9067 NC Primary

Addresses

Primary practice location

3725 Wrightsville Ave
Ste a
Wilmington, NC 28403-4041

Mailing address

3725 Wrightsville Ave
Ste a
Wilmington, NC 28403-4041
Phone (910) 799-9699

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160512001175 NC Order and Referring Only - DentistPractitioner - Dentist 3971892068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8564MDMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1174576516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 WRIGHTSVILLE AVE",
            "address_2": "STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034041",
            "telephone_number": "910-799-9699",
            "fax_number": "910-792-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 WRIGHTSVILLE AVE",
            "address_2": "STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034041",
            "telephone_number": "910-799-9699",
            "fax_number": "910-792-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINER",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "8564",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.