Active NPI
Dalissia Burke Grothe, PA-C
- Physician Assistant
- Gastonia, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-03189
- Practice address
- 870 Summit Crossing PL
Gastonia, NC 28054-2192 - Phone
- (704) 867-2333
- NPI assigned
- Oct 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-03189 | NC | Primary |
Addresses
Primary practice location
870 Summit Crossing PL
Gastonia, NC 28054-2192
Mailing address
4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2000
Other practice location 1
1021 Morehead Medical Dr
Suite A
Charlotte, NC 28204-2990
Phone (980) 442-2000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922383025 | Medicaid | NC | |
| 0397730010 | Other | NC | NSC |
| 8102779 | Medicaid | NC | |
| 1938PA | Medicaid | SC |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Florida College of Medicine, 2011
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
1915 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 323-2282
2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800
870 Summit Crossing PL
Gastonia, NC 28054-2192
Phone (704) 867-2333
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94 of 100
- Quality
- 81.63
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthocarolina | Physician Assistant | Current | Accepting new patients |
| Orthocarolina | Physician Assistant | Current | Accepting new patients |
| Orthocarolina | Physician Assistant | Past | Accepting new patients |
Locations
540 Mount Holly Medical Pkwy
Belmont, NC 28012
Phone (704) 323-3337
4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090
1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000
870 Summit Crossing Pl
Gastonia, NC 28054
Phone (704) 671-1860
124 Welton Way
Mooresville, NC 28117
Phone (704) 323-3799
Organizations & group practices 6
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.
-
- Orthopaedic Surgery Physician
- Charlotte, NC
- NPI 1497704217
-
- Anesthesiology Physician
- Charlotte, NC
- NPI 1396739884
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CaroMont Regional Medical Center
- General Acute Care Hospital
- Gastonia, NC
- NPI 1013918960
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1922383025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 PARK RD STE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282092290",
"telephone_number": "704-323-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "870 SUMMIT CROSSING PL",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542192",
"telephone_number": "704-867-2333"
}
],
"practiceLocations": [
{
"address_1": "1021 Morehead Medical Dr",
"address_2": "Suite A",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282042990",
"country_code": "US",
"telephone_number": "980-442-2000",
"fax_number": "704-355-5800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GROTHE",
"first_name": "DALISSIA",
"middle_name": "BURKE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-20",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-03189",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1922383025",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NSC",
"identifier": "0397730010",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8102779",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1938PA",
"state": "SC"
}
],
"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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.