Individual provider Active NPI

Funmilola Akingbala, FNP

  • Family Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1679085872
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5010012 Issued in NC
Practice address
1337 E Garrison Blvd
Gastonia, NC 28054-5127
Phone
(704) 865-3848
Fax
(704) 854-3086
NPI assigned
Oct 27, 2017
Last updated
Dec 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5010012 NC Primary

Addresses

Primary practice location

1337 E Garrison Blvd
Gastonia, NC 28054-5127

Mailing address

1337 E Garrison Blvd
Gastonia, NC 28054-5127
Phone (704) 865-3848

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
I20180322000429 NC Practitioner - Nurse Practitioner 6709148240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

1212 Spruce St
Suite 315
Belmont, NC 28012-3386
Phone (704) 865-3848

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5010012NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc CurrentSince Jan 15, 2022 Accepting new patients
Caromont Medical Group Inc CurrentSince Jan 15, 2022 Accepting new patients

Locations

1212 Spruce St
Ste 315
Belmont, NC 28012
Phone (704) 461-8253

1337 E Garrison Blvd
Gastonia, NC 28054
Phone (704) 671-5313

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1679085872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545127",
            "telephone_number": "704-865-3848",
            "fax_number": "704-854-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545127",
            "telephone_number": "704-865-3848",
            "fax_number": "704-854-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKINGBALA",
        "first_name": "FUNMILOLA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-27",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.