Organization Active NPI

Yatawara Gynecology Wellness and Aesthetics PC

  • Gynecology Physician
  • Salisbury, NC
National Provider Identifier
1922357284
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
YATAWARA GYNECOLOGY WELLNESS AND AESTHETICS PC
Practice address
415 Statesville Blvd
Salisbury, NC 28144-2317
Phone
(704) 754-8990
Fax
(704) 754-8991
NPI assigned
Sep 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Authorized official

Name
Gayle J Singleton-Yatawara, M.D.NPI 1679551980
Title
President
Phone
(704) 754-8990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

415 Statesville Blvd
Salisbury, NC 28144-2317

Mailing address

415 Statesville Blvd
Salisbury, NC 28144-2317
Phone (704) 754-8990

Other identifiers 1

IdentifierTypeStateIssuer
5921499MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121116000085 NC Part B Supplier - Clinic/Group Practice 1850542028 Receives reassigned benefits from 1 practitioner
Practice locations: Salisbury, NC

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9623/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1922357284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 STATESVILLE BLVD",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442317",
            "telephone_number": "704-754-8990",
            "fax_number": "704-754-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 STATESVILLE BLVD",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442317",
            "telephone_number": "704-754-8990",
            "fax_number": "704-754-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YATAWARA GYNECOLOGY WELLNESS AND AESTHETICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-02",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "SINGLETON-YATAWARA",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-754-8990",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5921499",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.