Individual provider Active NPI

Amber Danielle Gaither, M.D.

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1821343948
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C186237 Issued in CA
Practice address
10620 Park Rd Ste 202
Charlotte, NC 28210-0106
Phone
(704) 468-0350
Fax
(704) 468-0089
NPI assigned
Jul 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0116024734 VA
Pediatrics Physician 208000000X C186237 CA Primary

Addresses

Primary practice location

10620 Park Rd Ste 202
Charlotte, NC 28210-0106

Mailing address

10620 Park Rd Ste 202
Charlotte, NC 28210-0106
Phone (704) 468-0350

Other identifiers 1

IdentifierTypeStateIssuer
0116024734MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231031001212 CA Practitioner - Pediatric Medicine 4183070964 Reassigns benefits to 1 organization
I20260325003909 NC Practitioner - Pediatric Medicine 4183070964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4435 Golf Acres Dr
Charlotte, NC 28208-5947

PO Box
Suite 19305
Charlotte, NC 28219-9305

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C186237CAMDPediatrics Physician
0116024734VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Pediatrics CurrentSince Oct 1, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

4050 Barranca Pkwy
Ste 170
Irvine, CA 92604
Phone (949) 551-1090

Organizations & group practices 3

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": "1342224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1821343948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 PARK RD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100106",
            "telephone_number": "704-468-0350",
            "fax_number": "704-468-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 PARK RD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100106",
            "telephone_number": "704-468-0350",
            "fax_number": "704-468-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAITHER",
        "first_name": "AMBER",
        "middle_name": "DANIELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-14",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0116024734",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C186237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0116024734",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.