Luiz Renato Gazzola, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

9700964 Issued in NC

Practice address

300 Veazey Dr
Butner, NC 27509-1668

Phone

(919) 764-2223

Fax

(919) 764-5198

NPI assigned

Aug 30, 2006

Last updated

Oct 19, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Luiz Renato Almeida Gazzola Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1629188354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 NEW PARKSIDE DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275161162",
            "telephone_number": "919-933-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 VEAZEY DR",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275091668",
            "telephone_number": "919-764-2223",
            "fax_number": "919-764-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZZOLA",
        "first_name": "LUIZ",
        "middle_name": "RENATO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9700964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUIZ",
            "last_name": "GAZZOLA",
            "middle_name": "RENATO ALMEIDA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Earl Robert Forbes, LCSWA
• Alexandra Fox, LCSW
• Lesley Joanne Fraser-Ball, LBA, LCSWA
• Josef Fultz, LCSW
• James Douglas Garris, PHARMD
• Mobolanle O Gbadamosi, M.D.
• John Gentry, M.D.
• Traci Michelle Gescak, P-LCSW
• Beverly Gibbs, PLCSW
• Patricia Gibson

• Psychiatry Physician in Butner, NC
• Providers in Butner, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.