Individual provider Active NPI

William Edward Anthony Jr., MD

  • Family Medicine Physician
  • Gastonia, NC
National Provider Identifier
1336105220
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35254 Issued in NC
Practice address
311 W 3Rd Ave
Gastonia, NC 28052
Phone
(704) 865-7096
Fax
(704) 853-3735
NPI assigned
Apr 21, 2006
Last updated
Nov 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35254 NC Primary

Addresses

Primary practice location

311 W 3Rd Ave
Gastonia, NC 28052

Mailing address

311 W 3Rd Ave
Gastonia, NC 28052
Phone (704) 865-7096

Other identifiers 1

IdentifierTypeStateIssuer
8911584MedicaidNC

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
I20050412000909 NC Practitioner - Family Practice 7719924687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians
Anthony Medical Clinic PAGroup PAC ID 3971556861, 2 clinicians

Practice addresses (Care Compare)

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

311 W 3Rd Ave
Gastonia, NC 28052-4057
Phone (704) 865-7096

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35254NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony Medical Clinic, PA CurrentSince Aug 1, 1993 Accepting new patients

Locations

311 W 3rd Ave
Gastonia, NC 28052
Phone (704) 865-7096

Organizations & group practices 2

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 2

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1336105220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W 3RD AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28052",
            "telephone_number": "704-865-7096",
            "fax_number": "704-853-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W 3RD AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28052",
            "telephone_number": "704-865-7096",
            "fax_number": "704-853-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "WILLIAM",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "35254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911584",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.