Individual provider Active NPI

Gongqiao Zhang, PA-C

  • Physician Assistant
  • Ranson, WV
National Provider Identifier
1508918012
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
01492 Issued in WV
Practice address
100 Oak Lee Dr
Ranson, WV 25438-4879
Phone
(304) 930-0001
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002256 VA
Physician Assistant 363A00000X 01492 WV Primary

Addresses

Primary practice location

100 Oak Lee Dr
Ranson, WV 25438-4879

Mailing address

220 Campus Blvd Ste 100
Winchester, VA 22601-2896
Phone (154) 053-6510

Other practice location 1

160 Merchant St Ste 200
Winchester, VA 22603-4772
Phone (540) 536-5950

Other practice location 2

65 Riverton Commons Dr
Front Royal, VA 22630-6768
Phone (540) 635-0700

Other practice location 3

607 E Jubal Early Dr
Winchester, VA 22601-5178
Phone (540) 536-2232

Other practice location 4

415A South St
Front Royal, VA 22630-2115
Phone (540) 636-0495

Other practice location 5

33820 Old Valley Pike Ste 2
Strasburg, VA 22657-3793
Phone (540) 459-1310

Other practice location 6

97 Administrative Dr
Martinsburg, WV 25404-6378
Phone (304) 350-3200

Other practice location 7

120 Campus Dr # 101
Martinsburg, WV 25404-7552
Phone (681) 247-1250

Other identifiers 1

IdentifierTypeStateIssuer
01492OtherWVWEST VIRGINIA PA LICENSE

Electronic endpoints 8

TypeEndpointUseAffiliation
Direct Messaging Address gzhang111473@soc.inova.org
Direct Messaging Address gzhang111473@soc.inova.org
Direct Messaging Address gzhang111473@soc.inova.org
Direct Messaging Address gzhang111473@soc.inova.org
Direct Messaging Address gzhang111473@soc.inova.org
Direct Messaging Address gzhang111473@soc.inova.org
Direct Messaging Address gzhang111473@soc.inova.org
Direct Messaging Address gzhang111473@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100916000949 WV Practitioner - Physician Assistant 7517082399 Reassigns benefits to 1 organization
I20150407000750 VA Practitioner - Physician Assistant 7517082399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Mountain Health Physicians IncGroup PAC ID 9133405327, 90 clinicians
Valley Regional Enterprises, IncGroup PAC ID 0446164495, 53 clinicians

Practice addresses (Care Compare)

100 Oak Lee Dr
Ranson, WV 25438-4879
Phone (304) 930-0001

120 Campus Dr
Martinsburg, WV 25404-7552

160 Merchant St
Suite 200
Winchester, VA 22603-4772
Phone (540) 536-5950

607 E Jubal Early Dr
Winchester, VA 22601-5178
Phone (540) 536-2232

65 Riverton Commons Dr
Front Royal, VA 22630-6768
Phone (540) 635-0700

97 Administrative Dr
Martinsburg, WV 25404-6378

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002256VAMDPhysician Assistant
01492WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Mountain Health Physicians, Inc. CurrentSince Jun 21, 2017 Accepting new patients
East Mountain Health Physicians, Inc. CurrentSince Jun 21, 2017 Accepting new patients
Valley Regional Enterprises, Inc Past Accepting new patients
East Mountain Health Physicians, Inc. Past Accepting new patients
Warren Memorial Hospital, Inc. Past Accepting new patients

Locations

220 Campus Blvd
Ste 100
Winchester, VA 22601

220 Campus Blvd
Ste 200
Winchester, VA 22601
Phone (540) 536-0307

1004 Sushruta Dr
Ste D
Martinsburg, WV 25401
Phone (304) 262-2538

120 Campus Dr
Ste 101
Martinsburg, WV 25404
Phone (681) 247-1250

97 Administrative Dr
Martinsburg, WV 25404
Phone (304) 350-3200

100 Oak Lee Dr
Ranson, WV 25438
Phone (304) 350-0001

Interoperability endpoints

  • Direct secure messaging: gzhang111473@soc.inova.org
  • Direct secure messaging: gzhang111473@valleyhealth.direct-ci.com

Organizations & group practices 10

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1508918012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012896",
            "telephone_number": "154-053-6510",
            "fax_number": "304-428-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OAK LEE DR",
            "city": "RANSON",
            "state": "WV",
            "postal_code": "254384879",
            "telephone_number": "304-930-0001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Merchant St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226034772",
            "country_code": "US",
            "telephone_number": "540-536-5950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "65 Riverton Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Front Royal",
            "state": "VA",
            "postal_code": "226306768",
            "country_code": "US",
            "telephone_number": "540-635-0700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "607 E Jubal Early Dr",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226015178",
            "country_code": "US",
            "telephone_number": "540-536-2232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415A South St",
            "address_purpose": "LOCATION",
            "city": "Front Royal",
            "state": "VA",
            "postal_code": "226302115",
            "country_code": "US",
            "telephone_number": "540-636-0495",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33820 Old Valley Pike Ste 2",
            "address_purpose": "LOCATION",
            "city": "Strasburg",
            "state": "VA",
            "postal_code": "226573793",
            "country_code": "US",
            "telephone_number": "540-459-1310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "97 Administrative Dr",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254046378",
            "country_code": "US",
            "telephone_number": "304-350-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Campus Dr # 101",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254047552",
            "country_code": "US",
            "telephone_number": "681-247-1250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "GONGQIAO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-03-07",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002256",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEST VIRGINIA PA LICENSE",
            "identifier": "01492",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gzhang111473@soc.inova.org",
            "affiliation": "N",
            "address_1": "607 E Jubal Early Dr",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226015178",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gzhang111473@soc.inova.org",
            "affiliation": "N",
            "address_1": "160 Merchant St Ste 200",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226034772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gzhang111473@soc.inova.org",
            "affiliation": "N",
            "address_1": "65 Riverton Commons Dr",
            "city": "Front Royal",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226306768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gzhang111473@soc.inova.org",
            "affiliation": "N",
            "address_1": "97 Administrative Dr",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254046378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gzhang111473@soc.inova.org",
            "affiliation": "N",
            "address_1": "415A South St",
            "city": "Front Royal",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226302115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gzhang111473@soc.inova.org",
            "affiliation": "N",
            "address_1": "33820 Old Valley Pike Ste 2",
            "city": "Strasburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226573793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gzhang111473@soc.inova.org",
            "affiliation": "N",
            "address_1": "100 Oak Lee Dr",
            "city": "Ranson",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254384879",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gzhang111473@soc.inova.org",
            "affiliation": "N",
            "address_1": "120 Campus Dr # 101",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254047552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ranson, WV

Sources for this page

Verify at the official NPI Registry.