John E. Gaston MD Dba

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

22112 Issued in NC

Legal business name

JOHN E. GASTON MD DBA

Practice address

2312B Murchison Rd
Fayetteville, NC 28301-3518

Phone

(910) 488-6331

Fax

(910) 488-5351

NPI assigned

Mar 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Johnny Eugene Gaston, M.D.

Title

Dba

Phone

(910) 488-6331

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Fayetteville Pediatrics Other name

Locations

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306965389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312B MURCHISON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013518",
            "telephone_number": "910-488-6331",
            "fax_number": "910-488-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312B MURCHISON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013518",
            "telephone_number": "910-488-6331",
            "fax_number": "910-488-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN E. GASTON MD DBA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GASTON",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "DBA",
        "authorized_official_telephone_number": "910-488-6331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NC",
            "license": "22112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901585",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8934945",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayetteville Pediatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Blake Grayson Joeckel, MMS, PA-C
• Joel Hedgecoe, D.D.S., P.a.
• Johari Family Services, LLC
• Johari Family Services, LLC
• Johari Family Services,LLC
• John L. Phillips, DDS,PA
• Johnnie Johnson Jones, LPC
• Letitia P. Johnson-Arnold, MS, CHES, NBC-HWC
• Mari D. Johnson-Francis
• Tammy Michele Johnson-McKoy, LCSWA

• Health Maintenance Organization in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Health Maintenance Organization in North Carolina

• 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.