Active NPI
Vicki W Light, MD
- Obstetrics & Gynecology Physician
- Gastonia, NC
National Provider Identifier
1366407900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 39516
- Practice address
- 706 Summit Crossing PL
Gastonia, NC 28054-2175 - Phone
- (704) 854-3600
- Fax
- (704) 854-3619
- NPI assigned
- Apr 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 39516 | NC | Primary |
Addresses
Primary practice location
706 Summit Crossing PL
Gastonia, NC 28054-2175
Mailing address
706 Summit Crossing PL
Gastonia, NC 28054-2175
Phone (704) 854-3600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8951925 | Medicaid | NC |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39516 | NC | MD | Obstetrics & Gynecology Physician |
Interoperability endpoints
- vicki.light@21996835700740.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1366407900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "706 SUMMIT CROSSING PL",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542175",
"telephone_number": "704-854-3600",
"fax_number": "704-854-3619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 SUMMIT CROSSING PL",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542175",
"telephone_number": "704-854-3600",
"fax_number": "704-854-3619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIGHT",
"first_name": "VICKI",
"middle_name": "W",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-18",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NC",
"license": "39516",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8951925",
"state": "NC"
}
],
"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 May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.