Individual provider Active NPI

Samira Abhijit Shende, PA-C

  • Physician Assistant
  • Gastonia, NC
National Provider Identifier
1609786714
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-16876 Issued in NC
Practice address
1530 Union Rd Ste a
Gastonia, NC 28054-2201
Phone
(704) 867-6188
Fax
(704) 866-4437
NPI assigned
Sep 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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 0010-16876 NC Primary

Addresses

Primary practice location

1530 Union Rd Ste a
Gastonia, NC 28054-2201

Mailing address

1530 Union Rd Ste a
Gastonia, NC 28054-2201
Phone (704) 867-6188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1609786714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 UNION RD STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542201",
            "telephone_number": "704-867-6188",
            "fax_number": "704-866-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 UNION RD STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542201",
            "telephone_number": "704-867-6188",
            "fax_number": "704-866-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENDE",
        "first_name": "SAMIRA",
        "middle_name": "ABHIJIT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-16876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.