NPIMap

Organization Active NPI

Union Medical Clinic, PC

  • Internal Medicine Physician
  • Gastonia, NC
National Provider Identifier
1891956819
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9300555 Issued in NC
Legal business name
UNION MEDICAL CLINIC, PC
Practice address
1574 Union Rd
Suite a
Gastonia, NC 28054-5633
Phone
(704) 866-4607
Fax
(704) 866-5292
NPI assigned
Jun 23, 2008
Last updated
Sep 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Authorized official

Name
Dr. Donatus Ogu, MD
Title
Owner
Phone
(704) 866-4607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9300555 NC Primary

Addresses

Primary practice location

1574 Union Rd
Suite a
Gastonia, NC 28054-5633

Mailing address

1574 Union Rd
Suite a
Gastonia, NC 28054-5633
Phone (704) 866-4607

Other identifiers 2

IdentifierTypeStateIssuer
02334OtherNCBLUE CROSS BLUE SHIELD
8910826MedicaidNC

National Provider Directory

National Provider Directory

Locations

1307 Union Rd
Ste 110
Gastonia, NC 28054
Phone (704) 866-4607

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1891956819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1574 UNION RD",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545633",
            "telephone_number": "704-866-4607",
            "fax_number": "704-866-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1574 UNION RD",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545633",
            "telephone_number": "704-866-4607",
            "fax_number": "704-866-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION MEDICAL CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "OGU",
        "authorized_official_first_name": "DONATUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-866-4607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9300555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02334",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8910826",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.