Gaa Clinic LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

200300814 Issued in NC

Legal business name

GAA CLINIC LLC

Practice address

4009 W Wendover Ave
Greensboro, NC 27407-1904

Phone

(336) 389-3889

Fax

(336) 851-1418

NPI assigned

Mar 22, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Harold Dean Green

Title

Member / Manager

Phone

(336) 389-3889

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Denise Talbott, FNP-C

  • Family Nurse Practitioner
  • Greensboro, NC
  • NPI 1023491388
  NPD (past)

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1215468269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 W WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071904",
            "telephone_number": "336-389-3889",
            "fax_number": "336-851-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 W WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071904",
            "telephone_number": "336-389-3889",
            "fax_number": "336-851-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAA CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "MEMBER / MANAGER",
        "authorized_official_telephone_number": "336-389-3889",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NC",
            "license": "200300814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC",
            "identifier": "40091940",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• General Practice Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.