Anthony Medical Clinic, PA
Organization Active NPI Specialist · Gastonia, NC
NPI 1811933799 · NPPES record last updated Feb 26, 2025
Key facts
- NPI
- 1811933799
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 35254 (NC)
- Legal business name
- ANTHONY MEDICAL CLINIC, PA
- Practice address
- 311 W 3Rd Ave
Gastonia, NC 28052-4057 - Phone
- (704) 865-7096
- Fax
- (704) 853-3735
- NPI assigned
- Jun 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. William Edward Anthony Jr., M.D.
- Title
- Owner/Physician
- Phone
- (704) 865-7096
Practitioners 2
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0875581 | Anthony Medical Clinic PA | Provider-performed microscopy | Aug 24, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050303000157 | NC | Part B Supplier - Clinic/Group Practice | 3971556861 |
Receives reassigned benefits from 2 practitioners Practice locations: Gastonia, NC |
National Provider Directory
Locations
311 W 3rd Ave
Gastonia, NC 28052
Phone (704) 865-7096
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 35254 | NC | Yes |
Addresses
Primary practice location
311 W 3Rd Ave
Gastonia, NC 28052-4057
Mailing address
311 W 3Rd Ave
Gastonia, NC 28052-4057
Phone (704) 865-7096
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8911584 | Medicaid | NC |
Other providers in Gastonia, NC
- Mariah Nicole Andrews
- Kristina Alessi Andronica
- Lynda Ofori Anin
- Richard Ankrah
- Melissa Annechino
- Adelle Anthony-Williams
- Anna Anthony
- Latasha Samone Anthony
- Lori Ann Anthony
- William Edward Anthony Jr.
All providers in Gastonia, NC · Specialist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.