Gaston Medical Associates, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9501167 Issued in NC

Legal business name

GASTON MEDICAL ASSOCIATES, PA

Practice address

2664 Court Drive
Suite a
Gastonia, NC 28054-1449

Phone

(704) 861-9030

Fax

(704) 833-1234

NPI assigned

Nov 3, 2005

Organization subpart

No

Name

Dr. Olufolarin Akanfe Ajao, M.D.NPI 1528059920

Title

Co-President

Phone

(704) 861-9030

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olufolarin Akanfe Ajao, M.D.

  • Internal Medicine Physician
  • Gastonia, NC
  • NPI 1528059920

  Internal Medicine, NC

  Medicare reassignment Care Compare group NPD Authorized official
• Neville Washington Forbes, M.D.

  • Gastroenterology Physician
  • Gastonia, NC
  • NPI 1699766006

  Gastroenterology, NC

  Medicare reassignment Care Compare group NPD
• Debra Jackson Safrit, F.N.P.

  • Nurse Practitioner
  • Gastonia, NC
  • NPI 1720069917

  NC, Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Taneisha L Barnett, PA-C

  • Physician Assistant
  • Gastonia, NC
  • NPI 1003055088

  NC

  Medicare reassignment Care Compare group
• Brenda Chillcott Helms, FNP-BC

  • Family Nurse Practitioner
  • Gastonia, NC
  • NPI 1912673161

  NC

  Medicare reassignment NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BAIEDD

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 31, 2013.

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1366433773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2664 COURT DRIVE",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541449",
            "telephone_number": "704-861-9030",
            "fax_number": "704-833-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2664 COURT DRIVE",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541449",
            "telephone_number": "704-861-9030",
            "fax_number": "704-833-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON MEDICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "AJAO",
        "authorized_official_first_name": "OLUFOLARIN",
        "authorized_official_middle_name": "AKANFE",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "704-861-9030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9501167",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "9600912",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01441",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201734",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011FH",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gaston Hospice
• Gaston Lincoln Cleveland Mhddsa Progam
• Gaston Lincoln Cleveland Mhddsa Program
• Gaston Lincoln Cleveland Mhddsa Program
• Gaston Manor
• Gaston Medical Partners PLLC
• Gaston Memorial Home Health Care/Med.Inc.
• Gaston Memorial Hospital, Inc
• Gaston Memorial Hospital, Incorporated
• Gaston Memorial Hospital, Incorporated

• All providers in Gastonia, NC
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.