Individual provider Active NPI

Debra Jackson Safrit, F.N.P.

  • Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1720069917
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201734 Issued in NC
Practice address
2664 Court Drive
Suite a
Gastonia, NC 28054-1449
Phone
(704) 861-9030
Fax
(704) 833-1234
NPI assigned
Nov 7, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201734 NC Primary

Addresses

Primary practice location

2664 Court Drive
Suite a
Gastonia, NC 28054-1449

Mailing address

2664 Court Drive
Suite a
Gastonia, NC 28054-1449
Phone (704) 861-9030

Other identifiers 1

IdentifierTypeStateIssuer
7000947MedicaidNC

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
I20090618000781 NC Practitioner - Nurse Practitioner 7416008115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gaston Medical Associates PAGroup PAC ID 0244381945, 4 clinicians

Practice addresses (Care Compare)

2664 Court Dr
Gastonia, NC 28054-1449
Phone 70486190301012

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Medical Associates, PA Nurse Practitioner CurrentSince May 22, 2009 Accepting new patients

Locations

2664 Court Dr
Gastonia, NC 28054
Phone (704) 861-9030

2664 Court Dr
Ste A
Gastonia, NC 28054
Phone (704) 861-9030

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAIEDD

Organizations & group practices 1

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720069917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2664 COURT DRIVE",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541449",
            "telephone_number": "704-861-9030",
            "fax_number": "704-833-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2664 COURT DRIVE",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541449",
            "telephone_number": "704-861-9030",
            "fax_number": "704-833-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFRIT",
        "first_name": "DEBRA",
        "middle_name": "JACKSON",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000947",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.