Individual provider Active NPI

Sara Richard, PA

  • Physician Assistant
  • Gastonia, NC
National Provider Identifier
1881047033
Registry record updated Jun 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06573 Issued in NC
Practice address
660 Summit Crossing PL Ste 306
Gastonia, NC 28054-2183
Phone
(704) 671-7830
NPI assigned
Jul 22, 2016
Last updated
Jun 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-06573 NC Primary

Addresses

Primary practice location

660 Summit Crossing PL Ste 306
Gastonia, NC 28054-2183

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 671-7830

Other practice location 1

415 N Center St Ste 203
Hickory, NC 28601-5036
Phone (828) 323-8281

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
I20161103002324 NC Practitioner - Physician Assistant 1557649035 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc CurrentSince Aug 19, 2022 Accepting new patients
DLP Frye Medical Group LLC Physician Assistant CurrentSince Feb 18, 2019 Accepting new patients
DLP Frye Medical Group LLC CurrentSince Feb 18, 2019 Accepting new patients
Caromont Medical Group Inc CurrentSince Aug 19, 2022 Accepting new patients
Gaston Memorial Hospital, Incorporated PastSince May 29, 2022 Accepting new patients

Locations

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

915 Tate Blvd SE
Ste 186
Hickory, NC 28602
Phone (828) 449-8458

915 Tate Blvd SE
Ste 182
Hickory, NC 28602
Phone (828) 322-2005

415 N Center St
Ste 203
Hickory, NC 28601
Phone (828) 322-2005

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655596800000",
    "number": "1881047033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-671-7830",
            "fax_number": "704-671-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 SUMMIT CROSSING PL STE 306",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542183",
            "telephone_number": "704-671-7830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 N Center St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286015036",
            "country_code": "US",
            "telephone_number": "828-323-8281",
            "fax_number": "828-323-8322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "SARA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2022-06-19",
        "certification_date": "2022-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.