Individual provider Active NPI

Jaime J Vanourny, MD

  • Dermatology Physician
  • Gastonia, NC
National Provider Identifier
1508028093
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
201101796 Issued in NC
Practice address
959 Cox Rd
Gastonia, NC 28054-3420
Phone
(704) 866-7576
Fax
(704) 866-0106
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X R8536 IA
Dermatology Physician 207N00000X 201101796 NC Primary

Addresses

Primary practice location

959 Cox Rd
Gastonia, NC 28054-3420

Mailing address

1072 X Ray Dr
Gastonia, NC 28054-7488
Phone (704) 671-1094

Other practice location 1

13539 Reese Blvd W
Huntersville, NC 28078-7961
Phone (704) 892-4878

Other practice location 2

7476 Waterside Loop Rd
Denver, NC 28037-7679
Phone (704) 601-4381

Other names 1

  • Jaime J Reiland Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120320000765 NC Practitioner - Dermatology 0941460430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Iowa, RJ & L Carver College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Plastic Surgery and Dermatology PAGroup PAC ID 6800875188, 56 clinicians

Practice addresses (Care Compare)

105 Delta Park Dr
Shelby, NC 28150-3575
Phone 7046711094101

959 Cox Rd
Gastonia, NC 28054-3420
Phone (704) 866-0106

Merit-based Incentive Payment System (MIPS)

Final score
89.65 of 100Reported as group
Quality
91.92
Promoting interoperability
94
Improvement activities
40
Cost
78.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision110
Removal of skin lesions1268
Removal or shaving of skin growth1-10
Skin biopsy604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R8536IAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Plastic Surgery and Dermatology Dermatology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1508028093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547488",
            "telephone_number": "704-671-1094",
            "fax_number": "704-671-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 COX RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543420",
            "telephone_number": "704-866-7576",
            "fax_number": "704-866-0106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13539 Reese Blvd W",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787961",
            "country_code": "US",
            "telephone_number": "704-892-4878",
            "fax_number": "704-892-7453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7476 Waterside Loop Rd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "NC",
            "postal_code": "280377679",
            "country_code": "US",
            "telephone_number": "704-601-4381",
            "fax_number": "704-822-5997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANOURNY",
        "first_name": "JAIME",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "R8536",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "201101796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "REILAND",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.