Madison Gobbell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-06829 Issued in NC

Practice address

1524 E Morehead Street
Charlotte, NC 28207-1164

Phone

(704) 343-7018

NPI assigned

Oct 27, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Southeast Radiation Oncology Group, P.a.

  • Radiation Oncology Physician
  • Charlotte, NC
  • NPI 1568400109
  Medicare reassignment
• Piedmont Carolinas Radiation Therapy LLC

  • Radiation Oncology Clinic/Center
  • Lancaster, SC
  • NPI 1538485578
  NPD (past)

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1417409103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 E 35TH ST",
            "address_2": "APT 1O",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051164",
            "telephone_number": "865-679-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 E MOREHEAD STREET",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071164",
            "telephone_number": "704-343-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBBELL",
        "first_name": "MADISON",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marina Glushkova
• Michelle Glymph, ATC
• James F. Gnecco IV, DO
• Go PT First Inc.
• Go Your Own Way, Inc.
• God Got You & Your Purpose LLC
• God'S Choice Home Agency LLC
• God'S Production Ministries Inc
• Kenyatt Motti Godbolt, M.S., CCC-SLP
• Tanisha Godbolt

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.