Individual provider Active NPI

George Ayo Oluwa Korede, MD

  • Rheumatology Physician
  • Gastonia, NC
National Provider Identifier
1205163144
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
2018-00229 Issued in NC
Practice address
660 Summit Crossing PL Ste 302
Gastonia, NC 28054-2183
Phone
(704) 671-6438
Fax
(704) 671-6436
NPI assigned
Nov 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 2018-00229 NC Primary

Addresses

Primary practice location

660 Summit Crossing PL Ste 302
Gastonia, NC 28054-2183

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Other practice location 1

1 Medical Center Blvd
Winston-Salem, NC 27103
Phone (336) 716-2011

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
I20181001002923 NC Practitioner - Internal Medicine 2769733708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mercer University School of Medicine, 2013
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)

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2018-00229NCMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group, Inc. CurrentSince Aug 6, 2018 Accepting new patients
Caromont Medical Group Inc Rheumatology Current Accepting new patients
Caromont Medical Group Inc CurrentSince Aug 6, 2018 Accepting new patients

Locations

1212 Spruce St
Ste 311
Belmont, NC 28012
Phone (704) 825-5228

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

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

660 Summit Crossing Pl
Ste 302
Gastonia, NC 28054
Phone (704) 671-6438

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1258070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1205163144",
    "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",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 SUMMIT CROSSING PL STE 302",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542183",
            "telephone_number": "704-671-6438",
            "fax_number": "704-671-6436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston-Salem",
            "state": "NC",
            "postal_code": "27103",
            "country_code": "US",
            "telephone_number": "336-716-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOREDE",
        "first_name": "GEORGE",
        "middle_name": "AYO OLUWA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-13",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NC",
            "license": "2018-00229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.