NPIMap

Organization Active NPI

Mt Airy OB GYN Center, Inc

  • Obstetrics & Gynecology Physician
  • Mount Airy, NC
National Provider Identifier
1629057294
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
200001210578 Issued in NC
Legal business name
MT AIRY OB GYN CENTER, INC
Practice address
510 S South St
Mount Airy, NC 27030-4422
Phone
(336) 786-4522
Fax
(336) 789-3025
NPI assigned
Jan 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Authorized official

Name
Dr. Kenneth D Gitt, MDNPI 1902802598
Title
President
Phone
(336) 786-4522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 200001210578 NC Primary

Addresses

Primary practice location

510 S South St
Mount Airy, NC 27030-4422

Mailing address

510 S South St
Mount Airy, NC 27030-4422
Phone (336) 786-4522

Other identifiers 3

IdentifierTypeStateIssuer
02242OtherNCNC BLUE CROSS BLUE SHIELD
8902242MedicaidNC
0361OtherNCMEDICARE GROUP NUMBER

Other names 1

  • MT AIRY OB GYN CENTER, INC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1629057294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S SOUTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304422",
            "telephone_number": "336-786-4522",
            "fax_number": "336-789-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S SOUTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304422",
            "telephone_number": "336-786-4522",
            "fax_number": "336-789-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT AIRY OB GYN CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "GITT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-786-4522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "200001210578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BLUE CROSS BLUE SHIELD",
            "identifier": "02242",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902242",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "0361",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MT AIRY OB GYN CENTER, INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Airy, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.