Gaston Primary Care PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

200000171 Issued in NC

Legal business name

GASTON PRIMARY CARE PLLC

Practice address

760 N New Hope Rd
Suite B
Gastonia, NC 28054-4037

Phone

(704) 864-5969

Fax

(704) 864-5584

NPI assigned

May 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Azemobo Charles Akhimien, MD

Title

President

Phone

(704) 864-5969

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1366409484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550802",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280550802",
            "telephone_number": "704-864-5969",
            "fax_number": "704-864-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 N NEW HOPE RD",
            "address_2": "SUITE B",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544037",
            "telephone_number": "704-864-5969",
            "fax_number": "704-864-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "AKHIMIEN",
        "authorized_official_first_name": "AZEMOBO",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-864-5969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200000171",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "23016",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "51287",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891255W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gaston Memorial Hospital, Incorporated
• Gaston Memorial Hospital, Incorporated
• Gaston Neurological, PLLC
• Gaston Oral & Maxillofacial Surgery
• Gaston Pharmacy LLC
• Gaston Radiology
• Gaston Radiology PA
• Gaston Rehab Associates, Inc
• Gaston Residential Services, Icf/Mr, Inc.
• Gaston Residential Services, Icf/Mr, Inc.

• Internal Medicine Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.