Active NPI
Paul Gores
- Surgery Physician
- Charlotte, NC
National Provider Identifier
1699780346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 9401200
- Practice address
- 1350 S Kings Dr
Charlotte, NC 28207-2134 - Phone
- (704) 446-1255
- NPI assigned
- Jul 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 9401200 | NC | Primary |
Addresses
Primary practice location
1350 S Kings Dr
Charlotte, NC 28207-2134
Mailing address
1350 S Kings Dr
Charlotte, NC 28207-2134
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9401200 | NC | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555286400000",
"number": "1699780346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 S KINGS DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282072134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 S KINGS DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282072134",
"telephone_number": "704-446-1255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORES",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-30",
"last_updated": "2019-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "9401200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.