NPIMap

Organization Active NPI

Carolina Surgery PA

  • Surgery Physician
  • Gastonia, NC
National Provider Identifier
1245296490
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CAROLINA SURGERY PA
Practice address
1089 X Ray Dr
Gastonia, NC 28054-7489
Phone
(704) 864-8377
Fax
(704) 864-4442
NPI assigned
Apr 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Andrew Ira Light, MDNPI 1629035530
Title
President
Phone
(704) 864-8377

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1089 X Ray Dr
Gastonia, NC 28054-7489

Mailing address

1089 X Ray Dr
Gastonia, NC 28054-7489
Phone (704) 864-8377

Other names 1

  • Gaston General and Vascular Surgery Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245296490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1089 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547489",
            "telephone_number": "704-864-8377",
            "fax_number": "704-864-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1089 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547489",
            "telephone_number": "704-864-8377",
            "fax_number": "704-864-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "IRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-864-8377",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gaston General and Vascular Surgery",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.