Individual provider Active NPI

John Arthur Gantt, PA

  • Medical Physician Assistant
  • Apex, NC
National Provider Identifier
1376888313
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-03770 Issued in NC
Practice address
2046 Creekside Landing Dr
Apex, NC 27502-3982
Phone
(919) 303-4777
Fax
(919) 303-0077
NPI assigned
Dec 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-03770 NC Primary

Addresses

Primary practice location

2046 Creekside Landing Dr
Apex, NC 27502-3982

Mailing address

23095 Duck Pond Circle
Morrisville, NC 27560
Phone (919) 303-4777

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151005002341 NC Practitioner - Physician Assistant 5890003289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Surgery Center PAGroup PAC ID 3173599479, 72 clinicians

Practice addresses (Care Compare)

111 Foothills Dr
Suite B
Morganton, NC 28655-5123
Phone (828) 438-4683

1450 Professional Park Dr
Winston Salem, NC 27103-1300
Phone (336) 724-2434

506 Park Hill CT
Suite 1
Hendersonville, NC 28739-4333
Phone (828) 693-0275

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as group
Promoting interoperability
89
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-03770NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Surgery Center PA CurrentSince Oct 1, 2015 Accepting new patients

Locations

111 Foothills Dr
Ste B
Morganton, NC 28655
Phone (828) 437-8158

532 W Park Cir
North Wilkesboro, NC 28659
Phone (336) 667-6600

1450 Professional Park Dr
Winston Salem, NC 27103
Phone (336) 724-2434

1450 Professional Park Dr
Ste 100
Winston Salem, NC 27103

1450 Professional Park Dr
Ste 150
Winston Salem, NC 27103
Phone (336) 724-2434

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1376888313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23095 DUCK POND CIRCLE",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "27560",
            "telephone_number": "919-303-4777",
            "fax_number": "919-303-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 CREEKSIDE LANDING DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275023982",
            "telephone_number": "919-303-4777",
            "fax_number": "919-303-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTT",
        "first_name": "JOHN",
        "middle_name": "ARTHUR",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-03",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-03770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

Verify at the official NPI Registry.