Organization Active NPI

Asheboro Emergency Physicians PA

  • Emergency Medicine Physician
  • Asheboro, NC
National Provider Identifier
1689779720
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
78973 Issued in NC
Legal business name
ASHEBORO EMERGENCY PHYSICIANS PA
Practice address
364 White Oak St
Asheboro, NC 27203-5434
Phone
(336) 629-8807
NPI assigned
Sep 13, 2006
Last updated
Jun 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

Name
Marcus E. Gentry, DONPI 1891987194
Title
President
Phone
(336) 301-3240

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 78973 NC Primary

Addresses

Primary practice location

364 White Oak St
Asheboro, NC 27203-5434

Mailing address

PO Box 4337
Asheboro, NC 27204-4337
Phone (336) 301-3240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040717000225 NC Part B Supplier - Clinic/Group Practice 3476532920 Receives reassigned benefits from 51 practitioners
Practice locations: Asheboro, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1689779720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4337",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272044337",
            "telephone_number": "336-301-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 WHITE OAK ST",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035434",
            "telephone_number": "336-629-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHEBORO EMERGENCY PHYSICIANS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "GENTRY",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-301-3240",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "78973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.