Active NPI
Ivy at Gastonia LLC
- Skilled Nursing Facility
- Gastonia, NC
National Provider Identifier
1699336776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- IVY AT GASTONIA LLC
- Practice address
- 4414 Wilkinson Blvd
Gastonia, NC 28056-8271 - Phone
- (305) 912-9260
- NPI assigned
- Jun 27, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Chaim Hyman
- Title
- Ceo
- Phone
- (305) 912-9260
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
4414 Wilkinson Blvd
Gastonia, NC 28056-8271
Mailing address
9429 Harding Ave # 141
Surfside, FL 33154-2803
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0956051 | Ivy at Gastonia, the | Certificate of waiver | Sep 8, 2026 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Concord, NC
- NPI 1396851218
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1760054400000",
"number": "1699336776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9429 HARDING AVE # 141",
"city": "SURFSIDE",
"state": "FL",
"postal_code": "331542803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4414 WILKINSON BLVD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280568271",
"telephone_number": "305-912-9260"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IVY AT GASTONIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-06-27",
"last_updated": "2025-10-10",
"certification_date": "2025-10-10",
"status": "A",
"authorized_official_last_name": "HYMAN",
"authorized_official_first_name": "CHAIM",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "305-912-9260",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"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 Oct 10, 2025; 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.