Active NPI
Jonathan Duane Gaskins, LCSW
- Clinical Social Worker
- Yadkinville, NC
National Provider Identifier
1821116518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C005367
- Practice address
- 320 E Lee Ave
Yadkinville, NC 27055-8132 - Phone
- (336) 679-8805
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C005367 | NC | Primary |
Addresses
Primary practice location
320 E Lee Ave
Yadkinville, NC 27055-8132
Mailing address
284 Executive Park Dr
Suite 100
Concord, NC 28025
Phone (704) 939-1100
Other practice location 1
518 Signal Hill Drive Ext
Statesville, NC 28625-4391
Phone (704) 981-1045
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821116518 | Other | NC | GATEWAY |
| 1821116518 | Other | NC | UBH |
| 1821116518 | Medicaid | NC | |
| 19FDH | Other | NC | BCBS |
| 1821116518 | Other | NC | HUMANA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055360 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1821116518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR",
"address_2": "SUITE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "28025",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E LEE AVE",
"city": "YADKINVILLE",
"state": "NC",
"postal_code": "270558132",
"telephone_number": "336-679-8805"
}
],
"practiceLocations": [
{
"address_1": "518 Signal Hill Drive Ext",
"address_purpose": "LOCATION",
"city": "Statesville",
"state": "NC",
"postal_code": "286254391",
"country_code": "US",
"telephone_number": "704-981-1045",
"fax_number": "704-883-8638",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GASKINS",
"first_name": "JONATHAN",
"middle_name": "DUANE",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C005367",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1821116518",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH",
"identifier": "1821116518",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1821116518",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "19FDH",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "1821116518",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yadkinville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.