NPIMap

Organization Active NPI

Gastonia Pediatric Associates, PA

  • Pediatrics Physician
  • Gastonia, NC
National Provider Identifier
1679568992
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GASTONIA PEDIATRIC ASSOCIATES, PA
Practice address
1839 E Garrison Blvd
Gastonia, NC 28054-4839
Phone
(704) 864-2685
Fax
(704) 864-9363
NPI assigned
Sep 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Authorized official

Name
Dr. John C Watts,III, M.D.
Title
Vice President
Phone
(704) 864-2685

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X Primary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080A0000X

Addresses

Primary practice location

1839 E Garrison Blvd
Gastonia, NC 28054-4839

Mailing address

1839 E Garrison Blvd
Gastonia, NC 28054-4839
Phone (704) 864-2685

Other identifiers 1

IdentifierTypeStateIssuer
8901611MedicaidNC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0243046Gastonia Pediatric Associates PA1839 East Garrison Boulevard, Gastonia, NC 28054ComplianceJul 14, 2026

National Provider Directory

National Provider Directory

Locations

1839 E Garrison Blvd
Gastonia, NC 28054
Phone (704) 864-2684

Practitioners & affiliated clinicians

Practitioners 6

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": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370304000000",
    "number": "1679568992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544839",
            "telephone_number": "704-864-2685",
            "fax_number": "704-864-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544839",
            "telephone_number": "704-864-2685",
            "fax_number": "704-864-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTONIA PEDIATRIC ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2013-06-04",
        "status": "A",
        "authorized_official_last_name": "WATTS,III",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "704-864-2685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901611",
            "state": "NC"
        }
    ],
    "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 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.