Gerda Augustin, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

30878 Issued in WV

Practice address

108 W Pike St
Clarksburg, WV 26301-2721

Phone

(304) 918-9286

Fax

(304) 918-9287

NPI assigned

Jul 10, 2006

Last updated

Oct 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Destyoncall Pediatrics

  • Primary Care Clinic/Center
  • Stratford, NJ
  • NPI 1073749222
  NPD (past) Authorized official
• Lourdes Medical Associates PA

  • Family Medicine Physician
  • Haddon Heights, NJ
  • NPI 1568441541

  Pediatrics

  NPD (past)
• Lourdes Medical Associates, PA

  dba Lourdes Medical Associates Surigcal Specialists

  • Surgery Physician
  • Moorestown, NJ
  • NPI 1952645525
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1881628436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W PIKE ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012721",
            "telephone_number": "304-918-9286",
            "fax_number": "304-918-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W PIKE ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012721",
            "telephone_number": "304-918-9286",
            "fax_number": "304-918-9287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 S Black Horse Pike Ste 202",
            "address_purpose": "LOCATION",
            "city": "Blackwood",
            "state": "NJ",
            "postal_code": "080122959",
            "country_code": "US",
            "telephone_number": "856-352-6041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUGUSTIN",
        "first_name": "GERDA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA07823800",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD427933",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WV",
            "license": "30878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0063002",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Associated Podiatrists, PLLC
• Traci Atha
• Cindy Kay Audia
• Melisa Dawn Audia, NP
• Samantha Jo Audia, RN
• Shannon Ayers
• Teresa Azzopardi, PHARM.D.
• David Bacorn
• Jodi Pisegna Bailes, MSW
• Debora Bailey

• General Practice Physician in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• General Practice Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.