Individual provider Active NPI

Aixa Gonzalez, M.D.

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1801089941
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2016-00990 Issued in NC
Practice address
9939 Highway 151
San Antonio, TX 78251-1900
Phone
(210) 706-7800
Fax
(210) 949-9581
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25202 NE
Internal Medicine Physician 207R00000X 2016-00990 NC Primary

Addresses

Primary practice location

9939 Highway 151
San Antonio, TX 78251-1900

Mailing address

104 Mark Dr
Edenton, NC 27932-1756
Phone (252) 482-5171

Other practice location 1

104 Mark Dr
Edenton, NC 27932-1756
Phone (252) 482-5171

Other practice location 2

232 Green St
Williamston, NC 27892-2000
Phone (252) 809-6400

Other names 1

  • Aixa Perez Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160927002108 NC Practitioner - Internal Medicine 3476711912 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2016-00990NCMDInternal Medicine Physician
25202NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Williamston Clinic Corp Internal Medicine CurrentSince Aug 1, 2016 Accepting new patients
Vidant Medical Group LLC CurrentSince Jan 4, 2019 Accepting new patients

Locations

104 Mark Dr
Edenton, NC 27932
Phone (252) 482-5171

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

104 Medical Dr
Williamston, NC 27892
Phone (252) 809-6300

232 Green St
Williamston, NC 27892
Phone (252) 792-6611

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1801089941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MARK DR",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279321756",
            "telephone_number": "252-482-5171",
            "fax_number": "252-809-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9939 HIGHWAY 151",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511900",
            "telephone_number": "210-706-7800",
            "fax_number": "210-949-9581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Mark Dr",
            "address_purpose": "LOCATION",
            "city": "Edenton",
            "state": "NC",
            "postal_code": "279321756",
            "country_code": "US",
            "telephone_number": "252-482-5171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "232 Green St",
            "address_purpose": "LOCATION",
            "city": "Williamston",
            "state": "NC",
            "postal_code": "278922000",
            "country_code": "US",
            "telephone_number": "252-809-6400",
            "fax_number": "252-809-6405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "AIXA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "25202",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2016-00990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AIXA",
            "last_name": "PEREZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.