Individual provider Active NPI

Anita James Gribble, PA-C

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1386709830
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101793 Issued in NC
Practice address
2810 16TH St NE
Hickory, NC 28601-9600
Phone
(828) 324-0359
NPI assigned
Dec 26, 2006
Last updated
Jun 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 101793 NC Primary

Addresses

Primary practice location

2810 16TH St NE
Hickory, NC 28601-9600

Mailing address

2810 16TH St NE
Hickory, NC 28601-9600
Phone (828) 413-7105

Other practice location 1

1781 Tate Blvd SE Ste 204
Hickory, NC 28602-4216
Phone (828) 324-0359

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
I20150619001899 NC Practitioner - Physician Assistant 9537470323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Frye Medical Group LLCGroup PAC ID 8123397601, 125 clinicians

Practice addresses (Care Compare)

1781 Tate Blvd SE
Suite 204
Hickory, NC 28602-4216
Phone (828) 324-0359

915 Tate Blvd SE
Hickory, NC 28602-4042

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Frye Medical Group LLC Physician Assistant CurrentSince Jun 1, 2017 Accepting new patients
DLP Frye Medical Group LLC CurrentSince Jun 1, 2017 Accepting new patients

Locations

1105 Fairgrove Church Rd SE
Conover, NC 28613
Phone (828) 267-0551

1781 Tate Blvd SE
Ste 204
Hickory, NC 28602
Phone (828) 324-0359

2810 16th St NE
Hickory, NC 28601
Phone (828) 324-0359

915 Tate Blvd SE
Ste 182
Hickory, NC 28602
Phone (828) 322-2005

915 Tate Blvd SE
Ste 186
Hickory, NC 28602
Phone (828) 449-8458

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1386709830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 16TH ST NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286019600",
            "telephone_number": "828-413-7105",
            "fax_number": "866-888-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 16TH ST NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286019600",
            "telephone_number": "828-324-0359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1781 Tate Blvd SE Ste 204",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286024216",
            "country_code": "US",
            "telephone_number": "828-324-0359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIBBLE",
        "first_name": "ANITA",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.