Individual provider Active NPI

Gina Nicole Noble, PA-C

  • Physician Assistant
  • Mooresville, NC
National Provider Identifier
1528290574
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001008054 Issued in NC
Practice address
128 Medical Park Rd Ste 201
Mooresville, NC 28117-8579
Phone
(704) 235-1827
NPI assigned
Aug 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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 PA9105036 FL
Physician Assistant 363A00000X 001008054 NC Primary

Addresses

Primary practice location

128 Medical Park Rd Ste 201
Mooresville, NC 28117-8579

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 873-4277

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 265-5911

Other identifiers 1

IdentifierTypeStateIssuer
001372800MedicaidFL

Other names 1

  • Gina Nicole Hopper 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180710002065 NC Practitioner - Physician Assistant 8325185796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

128 Medical Park Rd
Suite 102
Mooresville, NC 28117-8578
Phone (704) 978-3566

129 Sherlock Dr
Statesville, NC 28625-1916
Phone (704) 838-8245

138 Sherlock Dr
Statesville, NC 28625-1916
Phone (704) 873-1021

142 Sherlock Dr
Statesville, NC 28625-1916
Phone (704) 838-8256

152 Sherlock Dr
Statesville, NC 28625-1916
Phone (704) 838-8210

208 Old Mocksville Rd
Statesville, NC 28625-1930
Phone (704) 878-2011

357 Williamson Rd
Mooresville, NC 28117-5935
Phone (704) 664-7328

359 Williamson Rd
Mooresville, NC 28117-5935
Phone (704) 235-1838

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, P.a. CurrentSince Jun 1, 2018 Accepting new patients
Piedmont Healthcare, PA CurrentSince Jun 1, 2018 Accepting new patients

Locations

128 Medical Park Rd
Ste 201
Mooresville, NC 28117
Phone (704) 230-1302

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

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": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1528290574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277",
            "fax_number": "704-978-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MEDICAL PARK RD STE 201",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178579",
            "telephone_number": "704-235-1827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-265-5911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "GINA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105036",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001008054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001372800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "HOPPER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.