Individual provider Active NPI

Wilton Carlyle Gay Jr., MD

  • Family Medicine Physician
  • Greenville, NC
National Provider Identifier
1881653889
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27455 Issued in NC
Practice address
2450 Emerald PL
Greenville, NC 27834-5784
Phone
(252) 551-1066
Fax
(252) 551-1067
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27455 NC Primary

Addresses

Primary practice location

2450 Emerald PL
Greenville, NC 27834-5784

Mailing address

2450 Emerald Place
Greenville, NC 27834
Phone (252) 551-1066

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207000441 NC Practitioner - Family Practice 7719955111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27455NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince May 1, 2013 Accepting new patients
Physicians East, P.a. Past Accepting new patients

Locations

2450 Emerald Pl
Greenville, NC 27834
Phone (252) 551-1066

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Organizations & group practices 2

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1881653889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 EMERALD PLACE",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27834",
            "telephone_number": "252-551-1066",
            "fax_number": "252-551-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 EMERALD PL",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345784",
            "telephone_number": "252-551-1066",
            "fax_number": "252-551-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAY",
        "first_name": "WILTON",
        "middle_name": "CARLYLE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "27455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.