Individual provider Active NPI

Melvin L Gaston, PA-C

  • Surgical Physician Assistant
  • Morehead City, NC
National Provider Identifier
1902877277
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10025 Issued in NC
Practice address
3714 Guardian Ave
Suite E
Morehead City, NC 28557-2974
Phone
(252) 222-5862
Fax
(252) 247-9469
NPI assigned
Jan 27, 2006
Last updated
Sep 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 10025 NC Primary

Addresses

Primary practice location

3714 Guardian Ave
Suite E
Morehead City, NC 28557-2974

Mailing address

3714 Guardian Ave
Suite E
Morehead City, NC 28557-2974
Phone (252) 222-5862

Other identifiers 1

IdentifierTypeStateIssuer
292212600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10025NCMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1902877277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3714 GUARDIAN AVE",
            "address_2": "SUITE E",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285572974",
            "telephone_number": "252-222-5862",
            "fax_number": "252-247-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3714 GUARDIAN AVE",
            "address_2": "SUITE E",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285572974",
            "telephone_number": "252-222-5862",
            "fax_number": "252-247-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTON",
        "first_name": "MELVIN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "10025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292212600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.