Individual provider Active NPI

Rebecca Ann Gates, PA-C

  • Physician Assistant
  • Jacksonville, NC
National Provider Identifier
1629608039
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-10475
Practice address
317 Western Blvd
Jacksonville, NC 28546-6379
Phone
(910) 577-2345
NPI assigned
Jan 24, 2020
Last updated
Aug 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 0010-10475 Primary

Addresses

Primary practice location

317 Western Blvd
Jacksonville, NC 28546-6379

Mailing address

317 Western Blvd
Jacksonville, NC 28546-6379
Phone (910) 577-2345

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
I20200914002922 NC Practitioner - Physician Assistant 6507284106 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ecep II PA CurrentSince Sep 1, 2022 Accepting new patients
Onslow Memorial Hospital Inc CurrentSince Feb 12, 2022 Accepting new patients
Ecep II PA CurrentSince Sep 1, 2022 Accepting new patients
Pender Memorial Hospital, Incorporated Past Accepting new patients

Locations

507 E Fremont St
Burgaw, NC 28425
Phone (910) 259-5451

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

151 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 662-8440

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

5301 Wrightsville Ave
Wilmington, NC 28403
Phone (910) 452-8100

Interoperability endpoints

  • Direct secure messaging: rgates1464860@direct.novanthealth.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1629608039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466379",
            "telephone_number": "910-577-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466379",
            "telephone_number": "910-577-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2022-08-30",
        "certification_date": "2022-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "0010-10475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.