Individual provider Active NPI

Kimberly Ann Stegmayer, PA-C

  • Physician Assistant
  • Gastonia, NC
National Provider Identifier
1245427400
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01567 Issued in NC
Practice address
2555 Court Dr
Suite 200
Gastonia, NC 28054-2134
Phone
(704) 867-2141
Fax
(704) 867-2308
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-01567 NC Primary
Surgical Physician Assistant 363AS0400X 011773 NY

Addresses

Primary practice location

2555 Court Dr
Suite 200
Gastonia, NC 28054-2134

Mailing address

2555 Court Dr
Suite 200
Gastonia, NC 28054-2134
Phone (704) 867-2141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-01567NCMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1245427400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 COURT DR",
            "address_2": "SUITE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542134",
            "telephone_number": "704-867-2141",
            "fax_number": "704-867-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR",
            "address_2": "SUITE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542134",
            "telephone_number": "704-867-2141",
            "fax_number": "704-867-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEGMAYER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01567",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011773",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 9, 2014; 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.