Active NPI
Perry W Aycock Jr., M.D.
- Internal Medicine Physician
- Gastonia, NC
National Provider Identifier
1922067057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 18386
- Practice address
- 660 Summit Crossing PL
Gastonia, NC 28054-2104 - Phone
- (704) 867-0735
- Fax
- (704) 867-0738
- NPI assigned
- Mar 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 18386 | NC | Primary |
| Gastroenterology Physician | 207RG0100X | 18386 | NC |
Addresses
Primary practice location
660 Summit Crossing PL
Gastonia, NC 28054-2104
Mailing address
660 Summit Crossing PL
Gastonia, NC 28054-2181
Phone (704) 867-0735
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8912405 | Medicaid | NC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18386 | NC | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caromont Medical Group Inc | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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": "1142640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392768000000",
"number": "1922067057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 SUMMIT CROSSING PL",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542181",
"telephone_number": "704-867-0735",
"fax_number": "704-867-0738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 SUMMIT CROSSING PL",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542104",
"telephone_number": "704-867-0735",
"fax_number": "704-867-0738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYCOCK",
"first_name": "PERRY",
"middle_name": "W",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-18",
"last_updated": "2014-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "18386",
"primary": true
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NC",
"license": "18386",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8912405",
"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 Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.