Individual provider Active NPI

Kathryn Carol O'Neil, PA-C

  • Physician Assistant
  • Gastonia, NC
National Provider Identifier
1669846200
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08373 Issued in NC
Practice address
3302 S New Hope Rd Ste 100B
Gastonia, NC 28056
Phone
(704) 879-4936
NPI assigned
Nov 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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 019197 NY
Physician Assistant 363A00000X 0010-08373 NC Primary

Addresses

Primary practice location

3302 S New Hope Rd Ste 100B
Gastonia, NC 28056

Mailing address

3302 S New Hope Rd Ste 100B
Gastonia, NC 28056-8317
Phone (704) 879-4936

Other practice location 1

3302 S New Hope Rd Ste 100B
Gastonia, NC 28056
Phone (704) 879-4936

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-08373NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integritas Wellness and Hormone Center Past Accepting new patients
Potomac Physician Associates Past Accepting new patients

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": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1669846200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 S NEW HOPE RD STE 100B",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280568317",
            "telephone_number": "704-879-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 S NEW HOPE RD STE 100B",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28056",
            "telephone_number": "704-879-4936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3302 S New Hope Rd Ste 100B",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "28056",
            "country_code": "US",
            "telephone_number": "704-879-4936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "KATHRYN",
        "middle_name": "CAROL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-19",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019197",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08373",
            "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 Jun 13, 2019; 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.